| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $58.10 | $58.10 | $149.40 | |
Aetna
| Professional | $58.10 | $78.02 | $78.02 | |
BCBS
| Professional | $124.94 | $167.25 | $186.75 | |
Cigna
| Professional | $95.40 | $95.40 | $140.06 | |
Medica
| Facility | $49.80 | $63.08 | $149.40 | |
Medica
| Professional | $42.65 | $99.60 | $166.00 | |
United
| Professional | $34.86 | $87.98 | $141.10 |