| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $67.55 | $67.55 | $67.55 | |
Aetna
| Professional | $67.55 | $77.20 | $82.47 | |
BCBS
| Professional | $137.85 | $137.85 | $137.85 | |
Cigna
| Facility | $97.54 | $97.54 | $97.54 | |
Cigna
| Professional | $71.20 | $97.54 | $97.54 | |
Medica
| Facility | $46.88 | $94.55 | $771.31 | |
Medica
| Professional | $48.41 | $95.96 | $159.36 | |
United
| Professional | $48.41 | $75.04 | $109.39 |