| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $113.74 | $113.74 | $113.74 | |
Aetna
| Professional | $113.74 | $129.54 | $129.54 | |
BCBS
| Professional | $146.16 | $172.82 | $177.12 | |
Cigna
| Professional | $179.25 | $181.04 | $227.65 | |
Medica
| Facility | $45.82 | $113.74 | $720.06 | |
Medica
| Professional | $62.28 | $103.83 | $151.03 | |
United
| Professional | $45.94 | $103.37 | $163.94 |