| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $151.44 | $151.44 | $151.44 | |
Aetna
| Professional | $57.66 | $111.17 | $151.44 | |
BCBS
| Professional | $124.95 | $124.95 | $124.95 | |
Cigna
| Facility | $111.50 | $111.50 | $111.50 | |
Cigna
| Professional | $111.50 | $111.50 | $241.88 | |
Medica
| Facility | $57.66 | $141.79 | $782.12 | |
Medica
| Professional | $53.48 | $83.81 | $150.74 | |
United
| Professional | $55.87 | $93.48 | $150.74 |