| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $23.67 | $23.68 | $23.68 | |
BCBS
| Facility | $18.75 | $130.02 | $175.87 | |
BCBS
| Professional | $18.75 | $18.75 | $18.75 | |
Cigna
| Facility | $120.00 | $120.00 | $150.00 | |
Cigna
| Professional | $70.50 | $75.72 | $88.13 | |
Medica
| Facility | $8.00 | $24.86 | $109.00 |