| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $133.80 | $133.80 | $133.80 | |
Aetna
| Professional | $133.80 | $143.10 | $167.40 | |
BCBS
| Professional | $22.30 | $22.30 | $22.30 | |
Cigna
| Facility | $147.10 | $147.10 | $147.10 | |
Cigna
| Professional | $107.38 | $125.04 | $147.10 | |
Medica
| Facility | $22.99 | $100.00 | $231.99 | |
Medica
| Professional | $7.86 | $14.58 | $32.35 | |
United
| Professional | $7.86 | $13.36 | $31.79 |