| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $112.32 | $112.32 | $112.32 | |
Aetna
| Professional | $83.00 | $112.32 | $130.69 | |
BCBS
| Facility | $181.57 | $181.57 | $181.57 | |
BCBS
| Professional | $137.99 | $172.49 | $181.57 | |
Cigna
| Professional | $2.00 | $2.00 | $2.00 | |
Medica
| Facility | $101.09 | $112.32 | $189.82 |