| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $337.50 | $337.50 | $337.50 | |
Aetna
| Professional | $337.50 | $337.50 | $355.26 | |
BCBS
| Professional | $355.26 | $355.26 | $355.26 | |
Cigna
| Professional | $170.00 | $170.00 | $170.00 | |
Medica
| Facility | $286.77 | $373.02 | $823.61 | |
Medica
| Professional | $134.94 | $289.70 | $404.06 | |
United
| Professional | $134.94 | $289.70 | $404.06 |