| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $182.08 | $929.28 | $2,000.00 | |
Aetna
| Facility | 54 | $136.56 | $136.56 | $157.13 |
Aetna
| Professional | $143.68 | $178.46 | $296.70 | |
BCBS
| Professional | $365.59 | $423.44 | $498.17 | |
Cigna
| Professional | $306.99 | $457.39 | $666.68 | |
Medica
| Facility | $182.08 | $236.70 | $401.09 | |
Medica
| Professional | $215.45 | $384.35 | $1,602.24 | |
United
| Professional | $213.25 | $349.23 | $452.19 |