| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $762.30 | $762.30 | $762.30 | |
Aetna
| Professional | $128.00 | $128.00 | $164.00 | |
BCBS
| Facility | $0.02 | $410.11 | $463.00 | |
BCBS
| Professional | $265.00 | $265.00 | $265.00 | |
Cigna
| Facility | $591.16 | $591.16 | $591.16 | |
United
| Professional | $84.00 | $120.00 | $288.45 |