| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $52.08 | $52.08 | $52.08 | |
Aetna
| Professional | $25.14 | $34.21 | $52.08 | |
BCBS
| Professional | $51.64 | $51.64 | $51.64 | |
Cigna
| Professional | $19.25 | $19.25 | $19.25 | |
Medica
| Facility | $26.16 | $52.08 | $113.18 | |
Medica
| Professional | $15.69 | $23.54 | $609.54 | |
United
| Professional | $15.69 | $23.54 | $32.45 |