| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $104.71 | $173.78 | $426.58 | |
Aetna
| Professional | 54 | $309.03 | $309.03 | $316.23 |
BCBS
| Facility | $436.52 | $436.52 | $562.34 | |
BCBS
| Professional | $147.91 | $147.91 | $173.78 | |
Cigna
| Professional | $95.50 | $169.82 | $269.15 | |
MVP Health Care
| Professional | $125.89 | $173.78 | $208.93 | |
United
| Professional | $141.25 | $169.82 | $302.00 |