| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $69.52 | $69.52 | $69.52 | |
Aetna
| Professional | $69.52 | $69.52 | $69.52 | |
BCBS
| Professional | $86.90 | $108.00 | $222.00 | |
Cigna
| Facility | $138.87 | $138.87 | $138.87 | |
Cigna
| Professional | $80.12 | $80.12 | $100.15 | |
United
| Professional | $29.20 | $29.20 | $69.52 |