| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $687.60 | $687.60 | $687.60 | |
Aetna
| Professional | $687.60 | $761.56 | $995.06 | |
BCBS
| Professional | $114.60 | $114.60 | $135.69 | |
Cigna
| Professional | $24.99 | $24.99 | $71.76 | |
Medica
| Facility | $95.58 | $653.22 | $1,186.19 | |
Medica
| Professional | $40.57 | $70.06 | $215.09 | |
United
| Professional | $40.57 | $67.08 | $199.28 |