| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $72.44 | $72.44 | $74.13 | |
Aetna
| Professional | $72.44 | $72.44 | $74.13 | |
BCBS
| Professional | $52.48 | $69.18 | $70.79 | |
Cigna
| Professional | $102.33 | $125.89 | $213.80 | |
Medica
| Facility | $74.13 | $109.65 | $223.87 | |
Medica
| Professional | $74.13 | $81.28 | $81.28 | |
United
| Professional | $74.13 | $81.28 | $81.28 |