| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $214.54 | $214.54 | $214.54 | |
Aetna
| Professional | $214.54 | $214.54 | $225.83 | |
BCBS
| Professional | $225.83 | $225.83 | $225.83 | |
Cigna
| Professional | $119.00 | $119.00 | $119.00 | |
Medica
| Facility | $199.85 | $237.12 | $523.54 | |
Medica
| Professional | $85.78 | $184.15 | $256.83 | |
United
| Professional | $85.78 | $184.15 | $256.83 |