| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $19.27 | $19.27 | $19.27 | |
BCBS
| Facility | $101.23 | $101.23 | $101.23 | |
Cigna
| Professional | $141.00 | $141.00 | $176.25 | |
Medica
| Facility | $19.27 | $19.27 | $33.72 | |
Medica
| Professional | $9.39 | $9.39 | $9.39 |