| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $277.20 | $277.20 | $277.20 | |
Aetna
| Professional | $277.20 | $277.20 | $291.79 | |
BCBS
| Professional | $291.79 | $291.79 | $291.79 | |
Cigna
| Professional | $153.00 | $153.00 | $153.00 | |
Medica
| Facility | $235.39 | $306.38 | $676.48 | |
Medica
| Professional | $110.83 | $237.97 | $331.90 | |
United
| Professional | $110.83 | $249.17 | $331.90 |