| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $16.29 | $16.29 | $16.29 | |
Aetna
| Professional | $16.29 | $16.29 | $307.51 | |
BCBS
| Professional | $146.37 | $172.46 | $188.76 | |
Cigna
| Professional | $281.33 | $281.33 | $281.33 | |
Medica
| Facility | $16.29 | $16.29 | $289.50 |