| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $196.32 | $196.32 | $196.32 | |
Aetna
| Professional | $75.00 | $98.16 | $123.68 | |
BCBS
| Facility | $48.50 | $132.21 | $467.05 | |
BCBS
| Professional | $55.56 | $80.81 | $624.40 | |
Cigna
| Facility | $96.58 | $96.58 | $96.58 | |
Cigna
| Professional | $96.58 | $96.58 | $96.58 | |
Medica
| Facility | $83.49 | $98.16 | $140.37 | |
Medica
| Professional | $103.33 | $110.97 | $117.84 | |
United
| Professional | $103.33 | $110.92 | $117.79 |