| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $96.80 | $96.80 | $121.00 | |
Aetna
| Professional | $96.80 | $100.43 | $121.00 | |
BCBS
| Professional | $96.01 | $107.99 | $116.94 | |
Cigna
| Professional | $102.85 | $102.85 | $102.85 | |
Medica
| Facility | $96.80 | $100.43 | $163.59 | |
Medica
| Professional | $110.00 | $110.00 | $123.20 | |
United
| Professional | $110.00 | $110.00 | $149.56 |