| 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 | $23.15 | |
BCBS
| Facility | $68.81 | $93.27 | $175.10 | |
Cigna
| Professional | $50.59 | $70.13 | $87.66 | |
Medica
| Facility | $23.15 | $27.78 | $52.90 | |
Medica
| Professional | $2.98 | $2.98 | $2.98 |