| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $113.58 | $113.58 | $113.58 | |
Aetna
| Professional | $82.75 | $113.58 | $151.63 | |
BCBS
| Professional | $201.64 | $245.22 | $269.45 | |
Cigna
| Professional | $119.09 | $230.42 | $340.76 | |
Medica
| Facility | $113.58 | $173.25 | $212.93 | |
Medica
| Professional | $116.93 | $211.88 | $686.29 | |
United
| Professional | $116.93 | $210.15 | $268.61 |