| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.12 | $25.12 | $25.12 | |
Aetna
| Professional | $25.12 | $25.12 | $42.66 | |
BCBS
| Facility | $93.33 | $93.33 | $912.01 | |
BCBS
| Professional | $74.13 | $93.33 | $93.33 | |
Cigna
| Professional | $154.88 | $154.88 | $154.88 | |
Medica
| Facility | $25.70 | $25.70 | $52.48 |