| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $122.69 | $122.69 | $122.69 | |
Aetna
| Professional | $57.57 | $90.56 | $122.69 | |
BCBS
| Professional | $148.74 | $148.74 | $148.74 | |
Cigna
| Facility | $81.17 | $81.17 | $81.17 | |
Cigna
| Professional | $81.17 | $81.17 | $180.47 | |
Medica
| Facility | $57.57 | $114.86 | $582.10 | |
Medica
| Professional | $41.00 | $68.70 | $135.47 | |
United
| Professional | $45.54 | $68.70 | $134.33 |