| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $112.68 | $112.68 | $112.68 | |
Aetna
| Professional | $15.24 | $112.68 | $241.71 | |
BCBS
| Professional | $0.02 | $0.02 | $0.03 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $29.83 | $29.83 | $94.75 |