| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $173.00 | $173.00 | $173.00 | |
BCBS
| Facility | $55.40 | $200.13 | $361.83 | |
BCBS
| Professional | $138.50 | $184.66 | $251.60 | |
Cigna
| Facility | $263.02 | $263.02 | $263.02 | |
Cigna
| Professional | $192.01 | $192.01 | $263.02 | |
Medica
| Facility | $161.19 | $173.00 | $190.30 | |
Medica
| Professional | $173.00 | $173.00 | $173.00 |