| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $404.13 | $404.13 | $404.13 | |
BCBS
| Professional | $590.96 | $590.96 | $590.96 | |
Cigna
| Professional | $104.51 | $104.51 | $104.51 | |
Medica
| Facility | $404.13 | $404.13 | $472.83 |