| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $100.00 | $114.82 | $147.91 | |
Ambetter
| Professional | $100.00 | $104.71 | $125.89 | |
Ambetter
| Professional | 25 | $125.89 | $125.89 | $158.49 |
BCBS
| Professional | $123.03 | $125.89 | $169.82 | |
Cigna
| Professional | $81.28 | $128.82 | $263.03 | |
Medica
| Facility | $81.28 | $128.82 | $575.44 | |
Medica
| Professional | $97.72 | $112.20 | $144.54 | |
United
| Professional | $97.72 | $112.20 | $144.54 |