| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $170.42 | $170.42 | $170.42 | |
Aetna
| Professional | $77.33 | $125.10 | $170.42 | |
BCBS
| Professional | $211.54 | $211.54 | $211.54 | |
Cigna
| Facility | $129.12 | $129.12 | $129.12 | |
Cigna
| Professional | $129.12 | $129.12 | $253.13 | |
Medica
| Facility | $77.33 | $151.63 | $911.54 | |
Medica
| Professional | $53.56 | $90.72 | $186.47 | |
United
| Professional | $53.56 | $83.07 | $180.45 |