| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $62.75 | $62.75 | $553.61 | |
Aetna
| Professional | $62.75 | $62.75 | $113.93 | |
BCBS
| Professional | $120.00 | $120.00 | $120.00 | |
Cigna
| Facility | $1,128.18 | $1,128.18 | $1,128.18 | |
Medica
| Facility | $62.75 | $71.54 | $213.33 | |
Medica
| Professional | $86.65 | $117.60 | $211.56 | |
United
| Professional | $92.84 | $117.60 | $148.55 |