| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $82.78 | $132.58 | $8,500.00 | |
Aetna
| Professional | $74.25 | $113.05 | $179.80 | |
Aetna
| Professional | 52 | $40.40 | $56.53 | $66.56 |
BCBS
| Professional | $167.67 | $216.27 | $308.64 | |
Cigna
| Professional | $164.68 | $251.57 | $353.15 | |
Medica
| Facility | $82.78 | $132.58 | $248.34 | |
Medica
| Professional | $134.25 | $247.39 | $993.12 | |
United
| Facility | $385.52 | $385.52 | $385.52 | |
United
| Professional | $131.75 | $209.56 | $347.53 |