| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 25 | $90.20 | $90.20 | $90.20 |
Aetna
| Professional | $86.09 | $120.56 | $188.18 | |
Aetna
| Professional | 25 | $26.28 | $26.28 | $147.68 |
BCBS
| Professional | $76.34 | $111.06 | $537.92 | |
Cigna
| Professional | $96.98 | $115.33 | $211.88 | |
Medica
| Facility | $100.00 | $144.83 | $601.01 | |
Medica
| Professional | $105.64 | $123.09 | $288.49 | |
United
| Professional | $105.64 | $123.09 | $241.56 |