| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $165.32 | $165.32 | $165.32 | |
Aetna
| Professional | $71.15 | $121.96 | $165.32 | |
BCBS
| Professional | $151.50 | $151.50 | $151.50 | |
Cigna
| Facility | $114.47 | $114.47 | $114.47 | |
Cigna
| Professional | $114.47 | $114.47 | $253.13 | |
Medica
| Facility | $74.30 | $154.77 | $821.01 | |
Medica
| Professional | $58.04 | $93.40 | $176.34 | |
United
| Professional | $61.32 | $91.97 | $176.34 |