| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $122.42 | $122.42 | $122.42 | |
Aetna
| Professional | $99.10 | $122.42 | $122.42 | |
Ambetter
| Professional | $91.80 | $91.80 | $91.80 | |
BCBS
| Professional | $72.08 | $84.80 | $84.80 | |
Cigna
| Professional | $9.85 | $9.85 | $9.85 | |
Medica
| Facility | $122.42 | $122.42 | $164.04 |