| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $67.36 | $67.36 | $67.36 | |
Aetna
| Professional | $67.36 | $67.36 | $67.36 | |
BCBS
| Facility | $115.50 | $115.50 | $138.60 | |
BCBS
| Professional | $84.20 | $104.00 | $216.00 | |
Cigna
| Facility | $134.69 | $134.69 | $134.69 | |
Cigna
| Professional | $41.45 | $77.23 | $96.54 | |
United
| Professional | $28.29 | $38.89 | $94.11 |