| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $122.78 | $122.78 | $315.72 | |
Aetna
| Professional | $122.78 | $164.88 | $164.88 | |
BCBS
| Professional | $264.02 | $353.43 | $394.65 | |
Cigna
| Professional | $201.54 | $201.54 | $295.88 | |
Medica
| Facility | $105.24 | $133.30 | $315.72 | |
Medica
| Professional | $89.45 | $210.48 | $350.80 | |
United
| Professional | $73.67 | $178.91 | $298.18 |