| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $56.23 | $56.23 | $89.13 | |
Aetna
| Professional | $58.88 | $81.28 | $173.78 | |
Ambetter
| Professional | $58.88 | $74.13 | $97.72 | |
BCBS
| Professional | $69.18 | $72.44 | $95.50 | |
Cigna
| Professional | $67.61 | $87.10 | $138.04 | |
Medica
| Facility | $75.86 | $97.72 | $204.17 | |
Medica
| Facility | AS | $35.48 | $35.48 | $35.48 |
Medica
| Professional | $63.10 | $83.18 | $467.74 | |
United
| Professional | $60.26 | $74.13 | $102.33 |