| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.46 | $21.46 | $21.46 | |
Aetna
| Professional | $17.30 | $21.46 | $21.83 | |
BCBS
| Professional | $49.52 | $58.26 | $64.09 | |
Cigna
| Professional | $22.28 | $22.28 | $22.28 | |
Medica
| Facility | $21.10 | $27.14 | $37.58 | |
Medica
| Professional | $193.44 | $193.44 | $193.44 |