| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $52.08 | $52.08 | $52.08 | |
Aetna
| Professional | $19.27 | $38.22 | $52.08 | |
BCBS
| Professional | $54.12 | $54.12 | $54.12 | |
Cigna
| Facility | $37.90 | $37.90 | $37.90 | |
Cigna
| Professional | $37.90 | $37.90 | $83.91 | |
Medica
| Facility | $19.27 | $48.75 | $272.00 | |
Medica
| Professional | $19.21 | $28.82 | $49.87 | |
United
| Professional | $19.21 | $28.82 | $50.39 |