| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $58.88 | $128.82 | $239.88 | |
Aetna
| Professional | 25 | $117.49 | $117.49 | $117.49 |
BCBS
| Professional | $104.71 | $138.04 | $186.21 | |
Cigna
| Professional | $91.20 | $117.49 | $181.97 | |
Medica
| Professional | $72.44 | $125.89 | $154.88 | |
United
| Professional | $72.44 | $125.89 | $158.49 |