| 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 | $180.00 | |
BCBS
| Facility | $462.77 | $517.53 | $517.53 | |
Cigna
| Professional | $9.85 | $9.85 | $9.85 | |
Medica
| Facility | $122.42 | $189.75 | $232.60 |