| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $39.68 | $39.68 | $39.68 | |
Aetna
| Professional | $39.68 | $39.68 | $88.40 | |
Anthem BCBS
| Professional | $37.38 | $37.38 | $52.87 | |
Cigna
| Professional | $14.86 | $14.86 | $14.86 | |
Medica
| Facility | $39.68 | $44.24 | $100.00 |