| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $173.78 | $257.04 | $489.78 | |
Aetna
| Professional | $173.78 | $208.93 | $257.04 | |
BCBS
| Professional | $363.08 | $524.81 | $616.60 | |
Cigna
| Professional | $316.23 | $316.23 | $398.11 | |
Medica
| Facility | $158.49 | $208.93 | $489.78 | |
Medica
| Professional | $104.71 | $295.12 | $489.78 | |
United
| Professional | $104.71 | $275.42 | $416.87 |