| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $167.82 | $167.82 | $167.82 | |
Aetna
| Professional | $81.02 | $105.75 | $167.82 | |
BCBS
| Professional | $166.36 | $166.36 | $166.36 | |
Cigna
| Professional | $62.01 | $62.01 | $62.01 | |
Medica
| Facility | $81.02 | $126.17 | $239.56 | |
Medica
| Professional | $50.55 | $75.83 | $835.71 | |
United
| Professional | $50.55 | $75.83 | $104.49 |