| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $147.12 | $147.12 | $147.12 | |
Aetna
| Professional | $87.57 | $87.57 | $400.00 | |
Anthem BCBS
| Professional | $0.85 | $1.00 | $69.20 | |
Cigna
| Professional | $285.29 | $285.29 | $285.29 | |
Medica
| Facility | $87.57 | $107.10 | $204.59 | |
Medica
| Professional | $614.00 | $614.00 | $614.00 | |
United
| Professional | $367.00 | $367.00 | $367.00 |