| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $123.64 | $123.64 | $123.64 | |
Aetna
| Professional | $123.64 | $126.32 | $126.32 | |
BCBS
| Professional | $158.88 | $187.86 | $192.54 | |
Cigna
| Professional | $174.75 | $176.50 | $221.93 | |
Medica
| Facility | $68.93 | $126.32 | $771.31 | |
Medica
| Professional | $62.70 | $108.93 | $137.43 | |
United
| Professional | $48.41 | $108.93 | $135.40 |