| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $79.89 | $79.89 | $79.89 | |
Aetna
| Professional | $79.89 | $90.03 | $443.50 | |
BCBS
| Professional | $27.37 | $32.25 | $35.86 | |
Cigna
| Professional | $89.12 | $156.24 | $248.93 | |
Medica
| Facility | $79.89 | $113.36 | $157.43 | |
Medica
| Professional | $81.40 | $133.57 | $579.79 | |
United
| Professional | $81.36 | $118.10 | $173.57 |