| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $96.10 | $96.10 | $96.10 | |
Aetna
| Professional | $69.12 | $96.10 | $105.40 | |
Ambetter
| Professional | $49.50 | $49.50 | $132.00 | |
BCBS
| Facility | $462.77 | $517.53 | $517.53 | |
Cigna
| Professional | $20.93 | $20.93 | $20.93 | |
Medica
| Facility | $96.10 | $148.96 | $182.59 | |
Medica
| Professional | $140.52 | $140.52 | $140.52 | |
Midlands
| Professional | $140.52 | $140.52 | $140.52 |