| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $23.15 | $23.15 | $23.15 | |
Aetna
| Professional | $23.15 | $23.15 | $84.75 | |
BCBS
| Facility | $56.27 | $56.27 | $56.27 | |
Cigna
| Professional | $70.13 | $70.83 | $89.06 | |
Medica
| Facility | $23.15 | $23.15 | $42.83 |