| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $9.60 | $9.60 | $9.60 | |
Aetna
| Professional | $9.60 | $9.60 | $9.60 | |
BCBS
| Professional | $62.36 | $73.48 | $80.42 | |
Cigna
| Professional | $56.63 | $70.78 | $195.53 | |
Medica
| Facility | $9.60 | $9.60 | $22.86 |