| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $22.51 | $22.51 | $22.51 | |
BCBS
| Facility | $18.67 | $19.14 | $23.93 | |
BCBS
| Professional | $14.36 | $19.14 | $31.83 | |
Cigna
| Facility | $77.00 | $77.00 | $77.00 | |
Cigna
| Professional | $20.89 | $20.89 | $192.19 | |
Medica
| Facility | $75.00 | $75.00 | $75.00 |