| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $107.60 | $107.60 | $107.60 | |
Aetna
| Professional | $36.50 | $36.50 | $107.60 | |
BCBS
| Professional | $138.29 | $163.50 | $167.57 | |
Cigna
| Professional | $131.25 | $132.56 | $166.69 | |
Medica
| Facility | $52.58 | $107.60 | $589.07 | |
Medica
| Professional | $47.11 | $62.76 | $117.83 | |
United
| Professional | $37.68 | $62.76 | $117.83 |