| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $122.20 | $122.20 | $152.61 | |
Aetna
| Professional | $77.61 | $108.29 | $300.00 | |
Ambetter
| Professional | $145.52 | $145.52 | $164.92 | |
BCBS
| Facility | $43.11 | $155.74 | $281.58 | |
BCBS
| Professional | $107.77 | $143.69 | $195.79 | |
Cigna
| Facility | $112.67 | $112.67 | $112.67 | |
Cigna
| Professional | $82.25 | $82.25 | $234.38 | |
Medica
| Facility | $58.07 | $135.24 | $939.42 | |
Medica
| Professional | $81.22 | $89.95 | $135.50 | |
United
| Professional | $81.30 | $89.95 | $135.50 |