| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $89.88 | $89.88 | $89.88 | |
Aetna
| Professional | $89.88 | $174.10 | $174.10 | |
BCBS
| Professional | $218.61 | $257.57 | $281.92 | |
Cigna
| Professional | $161.72 | $161.72 | $161.72 | |
Medica
| Facility | $89.88 | $116.84 | $269.64 |