| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $132.16 | $132.16 | $132.16 | |
Aetna
| Professional | $52.76 | $97.02 | $132.16 | |
BCBS
| Professional | $148.52 | $148.52 | $148.52 | |
Cigna
| Facility | $94.65 | $94.65 | $94.65 | |
Cigna
| Professional | $94.65 | $94.65 | $207.19 | |
Medica
| Facility | $52.76 | $123.74 | $679.35 | |
Medica
| Professional | $47.05 | $73.15 | $137.93 | |
United
| Professional | $48.76 | $73.15 | $137.93 |