| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $171.15 | $171.15 | $171.15 | |
Aetna
| Professional | $171.15 | $171.15 | $171.15 | |
BCBS
| Professional | $389.30 | $458.68 | $502.04 | |
Cigna
| Professional | $420.38 | $424.58 | $533.88 | |
Medica
| Facility | $171.15 | $171.15 | $316.63 |