| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.47 | $25.47 | $25.47 | |
Aetna
| Professional | $25.47 | $25.47 | $52.40 | |
BCBS
| Facility | $92.66 | $92.66 | $545.42 | |
BCBS
| Professional | $71.90 | $92.66 | $92.66 | |
Cigna
| Professional | $155.19 | $155.19 | $155.19 | |
Medica
| Facility | $25.47 | $25.47 | $52.40 |