| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $138.24 | $138.24 | $138.24 | |
Aetna
| Professional | $138.24 | $174.93 | $174.93 | |
BCBS
| Professional | $174.06 | $175.37 | $206.32 | |
Cigna
| Professional | $216.75 | $216.75 | $270.94 | |
Medica
| Facility | $132.13 | $138.24 | $414.72 | |
Medica
| Professional | $138.24 | $249.75 | $298.36 | |
United
| Professional | $138.24 | $249.75 | $320.57 |