| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $170.20 | $170.20 | $170.20 | |
Aetna
| Professional | $23.02 | $24.27 | $24.34 | |
BCBS
| Facility | $31.37 | $34.86 | $36.40 | |
BCBS
| Professional | $39.22 | $39.22 | $39.22 | |
Cigna
| Facility | $87.30 | $87.30 | $87.30 | |
Cigna
| Professional | $19.23 | $19.23 | $19.23 | |
United
| Professional | $13.81 | $17.76 | $47.36 |