| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $117.57 | $155.18 | $264.89 | |
Aetna
| Professional | 25 | $587.00 | $587.00 | $587.00 |
Ambetter
| Professional | $172.90 | $172.90 | $172.90 | |
Ambetter
| Professional | 25 | $146.97 | $146.97 | $146.97 |
BCBS
| Professional | $104.25 | $151.63 | $734.47 | |
Cigna
| Professional | $132.57 | $148.04 | $267.97 | |
Medica
| Facility | $100.00 | $197.80 | $820.50 | |
Medica
| Professional | $135.28 | $159.12 | $372.26 | |
United
| Professional | $135.28 | $156.88 | $311.70 |