| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $111.38 | $111.38 | $111.38 | |
Aetna
| Professional | $111.38 | $126.86 | $126.86 | |
BCBS
| Professional | $143.13 | $169.23 | $173.44 | |
Cigna
| Professional | $175.50 | $177.26 | $222.89 | |
Medica
| Facility | $66.65 | $118.49 | $705.18 | |
Medica
| Professional | $60.99 | $76.37 | $121.97 | |
United
| Professional | $38.24 | $76.37 | $151.46 |