| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $122.42 | $122.42 | $122.42 | |
Aetna
| Professional | $99.11 | $122.42 | $122.42 | |
BCBS
| Facility | $231.42 | $243.60 | $500.04 | |
BCBS
| Professional | $194.88 | $236.29 | $243.60 | |
Cigna
| Professional | $9.85 | $9.85 | $9.85 | |
Medica
| Facility | $100.00 | $122.42 | $206.89 |