| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $118.75 | $161.52 | $282.80 | |
Aetna
| Professional | $118.75 | $138.46 | $168.90 | |
Anthem BCBS
| Professional | $38.79 | $70.00 | $70.00 | |
Cigna
| Professional | $288.99 | $288.99 | $363.38 | |
Medica
| Facility | $118.75 | $164.02 | $318.25 | |
Medica
| Professional | $661.43 | $661.43 | $661.43 |