| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $67.20 | $67.20 | $67.20 | |
Aetna
| Professional | $67.20 | $69.72 | $84.00 | |
BCBS
| Professional | $62.48 | $73.76 | $74.81 | |
Cigna
| Professional | $59.25 | $71.40 | $75.25 | |
Medica
| Facility | $67.20 | $87.36 | $119.70 | |
Medica
| Professional | $79.80 | $79.80 | $429.65 | |
United
| Professional | $79.80 | $79.80 | $86.67 |