| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $29.21 | $33.10 | $38.94 | |
Aetna
| Professional | $32.27 | $44.90 | $108.90 | |
Aetna
| Professional | 25 | $111.60 | $111.60 | $111.60 |
BCBS
| Professional | $93.93 | $103.33 | $121.85 | |
Cigna
| Professional | $51.41 | $92.14 | $139.19 | |
Medica
| Facility | $33.10 | $66.20 | $86.79 | |
Medica
| Professional | $40.06 | $75.45 | $160.08 | |
Medica
| Professional | 25 | $123.24 | $123.24 | $123.24 |
United
| Professional | $40.06 | $71.44 | $101.11 |