| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $133.91 | $133.91 | $133.91 | |
Aetna
| Professional | $62.92 | $104.86 | $127.54 | |
Anthem BCBS
| Professional | $18.10 | $28.51 | $49.07 | |
Cigna
| Professional | $128.30 | $128.30 | $137.59 | |
United
| Professional | $100.04 | $150.91 | $305.95 |