| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $175.28 | $175.28 | $175.28 | |
Aetna
| Professional | $143.75 | $175.28 | $175.28 | |
Anthem BCBS
| Professional | $30.00 | $30.00 | $30.00 | |
Cigna
| Professional | $141.65 | $323.10 | $323.10 | |
Medica
| Facility | $175.28 | $190.55 | $392.63 | |
Medica
| Professional | $115.97 | $115.97 | $115.97 |