| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $63.10 | $63.10 | $114.82 | |
Aetna
| Professional | $63.10 | $63.10 | $81.28 | |
BCBS
| Facility | $69.18 | $69.18 | $70.79 | |
BCBS
| Professional | $52.48 | $69.18 | $70.79 | |
Cigna
| Facility | $64.57 | $64.57 | $74.13 | |
Cigna
| Professional | $64.57 | $64.57 | $81.28 | |
Medica
| Facility | $58.88 | $63.10 | $186.21 | |
Medica
| Professional | $63.10 | $69.18 | $69.18 | |
United
| Professional | $64.57 | $70.79 | $70.79 |