| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $174.10 | $174.10 | $174.10 | |
Aetna
| Professional | $89.88 | $174.10 | $253.70 | |
BCBS
| Facility | $1,940.71 | $3,034.83 | $4,722.57 | |
Cigna
| Professional | $161.72 | $161.72 | $161.72 | |
Medica
| Facility | $174.10 | $174.10 | $248.96 | |
Medica
| Professional | $690.53 | $690.53 | $690.53 |