| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $29.28 | $29.28 | $29.28 | |
Aetna
| Professional | $20.83 | $20.83 | $29.28 | |
BCBS
| Facility | $84.61 | $274.02 | $527.21 | |
BCBS
| Professional | $64.81 | $86.42 | $108.02 | |
Cigna
| Facility | $55.00 | $58.00 | $82.00 | |
Medica
| Facility | $20.83 | $29.28 | $100.00 | |
Medica
| Professional | $272.97 | $272.97 | $272.97 |