| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $158.91 | $158.91 | $158.91 | |
Aetna
| Professional | $158.91 | $158.91 | $158.91 | |
BCBS
| Facility | $172.41 | $173.27 | $174.57 | |
BCBS
| Professional | $146.55 | $173.01 | $175.50 | |
Cigna
| Professional | $151.58 | $153.09 | $189.47 | |
Medica
| Facility | $144.43 | $160.51 | $654.50 | |
Medica
| Professional | $63.57 | $158.91 | $177.99 | |
United
| Professional | $63.57 | $158.91 | $177.99 |