| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.67 | $20.67 | $20.67 | |
Aetna
| Professional | $6.66 | $15.17 | $20.67 | |
BCBS
| Professional | $26.60 | $26.60 | $26.60 | |
Cigna
| Facility | $14.58 | $14.58 | $14.58 | |
Cigna
| Professional | $14.58 | $14.58 | $33.28 | |
Medica
| Facility | $6.66 | $19.35 | $104.64 | |
Medica
| Professional | $7.18 | $11.44 | $17.39 | |
United
| Professional | $7.18 | $11.44 | $17.39 |