| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.00 | $30.00 | $30.00 | |
Aetna
| Professional | $30.00 | $30.00 | $30.00 | |
BCBS
| Professional | $28.25 | $28.25 | $28.25 | |
Cigna
| Professional | $14.68 | $14.68 | $14.68 | |
Medica
| Facility | $30.00 | $31.50 | $66.56 | |
Medica
| Professional | $14.77 | $22.16 | $189.44 | |
United
| Professional | $14.77 | $22.16 | $36.93 |