| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $133.38 | $133.38 | $133.38 | |
Aetna
| Professional | $63.06 | $87.39 | $133.38 | |
BCBS
| Facility | $188.74 | $205.92 | $218.42 | |
BCBS
| Professional | $204.40 | $204.40 | $204.40 | |
Cigna
| Facility | $133.72 | $133.72 | $133.72 | |
Cigna
| Professional | $97.62 | $133.72 | $200.63 | |
Medica
| Facility | $63.06 | $133.38 | $620.42 | |
Medica
| Professional | $65.12 | $109.97 | $245.30 | |
United
| Professional | $65.12 | $106.30 | $147.29 |