| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.12 | $25.12 | $25.12 | |
Aetna
| Professional | $19.95 | $20.89 | $21.88 | |
BCBS
| Facility | $1.00 | $16.22 | $16.98 | |
BCBS
| Professional | $177.83 | $208.93 | $363.08 | |
Cigna
| Facility | $85.11 | $85.11 | $85.11 | |
Cigna
| Professional | $114.82 | $114.82 | $114.82 | |
Medica
| Facility | $20.42 | $25.70 | $79.43 | |
Medica
| Professional | $97.72 | $97.72 | $97.72 |