| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $104.10 | $104.10 | $104.10 | |
Aetna
| Professional | $104.10 | $121.01 | $138.24 | |
BCBS
| Professional | $161.41 | $161.41 | $189.90 | |
Cigna
| Professional | $107.43 | $107.43 | $175.16 | |
Medica
| Facility | $99.27 | $121.06 | $154.72 | |
Medica
| Professional | $132.32 | $157.24 | $768.84 | |
United
| Professional | $127.20 | $147.28 | $199.40 |