| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $69.77 | $85.32 | $138.75 | |
Aetna
| Professional | 25 | $319.00 | $319.00 | $319.00 |
Ambetter
| Professional | $102.60 | $102.60 | $102.60 | |
Ambetter
| Professional | 25 | $87.21 | $87.21 | $87.21 |
BCBS
| Professional | $61.91 | $90.06 | $436.21 | |
Cigna
| Professional | $77.52 | $84.86 | $144.58 | |
Medica
| Facility | $82.08 | $117.37 | $487.47 | |
Medica
| Professional | $75.81 | $87.38 | $203.12 | |
United
| Professional | $75.56 | $87.38 | $170.08 |