| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $316.23 | $758.58 | $1,096.48 | |
Aetna
| Professional | $316.23 | $316.23 | $436.52 | |
Anthem BCBS
| Professional | $3.98 | $3.98 | $3.98 | |
Cigna
| Professional | $52.48 | $52.48 | $52.48 | |
Medica
| Facility | $316.23 | $363.08 | $851.14 | |
United
| Facility | $263.03 | $275.42 | $1,096.48 |