| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $45.00 | $45.00 | $45.00 | |
Aetna
| Professional | $45.00 | $45.00 | $45.00 | |
BCBS
| Facility | $1,054.48 | $1,054.48 | $6,896.74 | |
BCBS
| Professional | $843.58 | $1,054.48 | $1,054.48 | |
Cigna
| Facility | $379.93 | $379.93 | $379.93 | |
Cigna
| Professional | $277.35 | $379.93 | $379.93 | |
Medica
| Facility | $45.00 | $46.35 | $90.00 | |
Medica
| Professional | $4,790.84 | $4,790.84 | $4,790.84 | |
United
| Professional | $4,790.84 | $4,790.84 | $4,790.84 |