| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $56.40 | $56.40 | $56.40 | |
Aetna
| Professional | $56.40 | $114.73 | $114.73 | |
BCBS
| Professional | $69.73 | $82.16 | $89.93 | |
Cigna
| Professional | $1.62 | $1.62 | $1.62 | |
Medica
| Facility | $56.40 | $73.31 | $137.93 |