| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $107.90 | $153.02 | $268.95 | |
Aetna
| Professional | $108.54 | $153.72 | $225.49 | |
Aetna
| Professional | 25 | $322.14 | $322.14 | $322.14 |
Anthem BCBS
| Professional | $119.28 | $155.83 | $256.75 | |
Cigna
| Professional | $151.02 | $238.70 | $339.91 | |
Medica
| Facility | $167.38 | $394.58 | $820.50 | |
Medica
| Professional | $137.37 | $167.09 | $273.99 | |
United
| Professional | $137.37 | $169.88 | $279.97 |