| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $63.71 | $63.71 | $63.71 |
Aetna
| Professional | 26 | $63.71 | $63.71 | $291.50 |
Ambetter
| Professional | 26 | $74.38 | $74.38 | $74.38 |
BCBS
| Professional | 26 | $73.40 | $104.86 | $115.35 |
Cigna
| Professional | 26 | $105.53 | $156.90 | $612.38 |
United
| Professional | 26 | $79.30 | $104.79 | $153.12 |