| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $138.91 | $138.91 | $138.91 | |
Aetna
| Professional | $138.91 | $138.91 | $138.91 | |
BCBS
| Facility | $29.45 | $33.33 | $37.11 | |
Cigna
| Facility | $177.00 | $177.00 | $177.00 | |
Medica
| Facility | $138.91 | $143.09 | $194.49 |