| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $140.00 | $140.00 | $140.00 | |
Aetna
| Professional | $140.00 | $140.00 | $140.00 | |
BCBS
| Facility | $118.41 | $120.78 | $697.01 | |
BCBS
| Professional | $96.62 | $120.78 | $120.78 | |
Cigna
| Facility | $223.29 | $223.29 | $223.29 | |
Cigna
| Professional | $157.41 | $163.00 | $163.00 | |
Medica
| Facility | $140.00 | $140.00 | $285.00 | |
Medica
| Professional | $113.76 | $170.65 | $331.01 | |
United
| Professional | $113.76 | $170.65 | $331.01 |