| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $121.56 | $121.56 | $312.58 | |
Aetna
| Professional | $121.56 | $163.24 | $163.24 | |
BCBS
| Professional | $261.39 | $349.92 | $390.74 | |
Cigna
| Professional | $199.48 | $199.48 | $292.83 | |
Medica
| Facility | $104.20 | $131.97 | $312.58 | |
Medica
| Professional | $182.53 | $347.32 | $1,367.63 | |
United
| Professional | $104.20 | $242.77 | $428.43 |