| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $22.16 | $22.16 | $22.16 | |
BCBS
| Facility | $101.23 | $101.23 | $101.23 | |
Cigna
| Professional | $113.63 | $113.63 | $142.03 | |
Medica
| Facility | $22.16 | $22.16 | $38.78 | |
Medica
| Professional | $5.23 | $5.23 | $5.23 |