| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $126.60 | $126.60 | $126.60 | |
Aetna
| Professional | $62.92 | $104.86 | $126.60 | |
Cigna
| Professional | $13.40 | $13.40 | $13.40 | |
Horizon BCBS
| Professional | $85.57 | $104.47 | $181.81 | |
United
| Professional | $7.72 | $109.41 | $238.50 |