| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $160.66 | $160.66 | $160.66 | |
Aetna
| Professional | $58.07 | $105.26 | $160.66 | |
BCBS
| Facility | $168.13 | $177.53 | $194.57 | |
BCBS
| Professional | $183.90 | $183.90 | $183.90 | |
Cigna
| Facility | $112.67 | $112.67 | $112.67 | |
Cigna
| Professional | $82.25 | $112.67 | $292.97 | |
Medica
| Facility | $58.07 | $156.38 | $939.42 | |
Medica
| Professional | $59.97 | $96.80 | $247.91 | |
United
| Professional | $59.97 | $96.80 | $129.66 |