| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $162.18 | $165.96 | $165.96 | |
Aetna
| Professional | $162.18 | $162.18 | $275.42 | |
Ambetter
| Professional | $95.50 | $100.00 | $107.15 | |
BCBS
| Facility | $123.03 | $144.54 | $478.63 | |
BCBS
| Professional | $134.90 | $138.04 | $144.54 | |
Cigna
| Professional | $162.18 | $162.18 | $199.53 | |
Medica
| Facility | $125.89 | $309.03 | $489.78 | |
Medica
| Professional | $165.96 | $181.97 | $199.53 | |
United
| Facility | $104.71 | $173.78 | $275.42 | |
United
| Professional | $165.96 | $181.97 | $194.98 |