| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $52.46 | $52.46 | $52.46 | |
Aetna
| Professional | $15.17 | $28.28 | $52.46 | |
BCBS
| Professional | $52.00 | $52.00 | $52.00 | |
Cigna
| Professional | $19.38 | $19.38 | $19.38 | |
Medica
| Facility | $26.23 | $40.14 | $91.26 | |
Medica
| Professional | $15.80 | $23.70 | $319.80 | |
United
| Professional | $15.80 | $23.70 | $32.65 |