| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.90 | $21.90 | $21.90 | |
Aetna
| Professional | $21.90 | $21.90 | $21.90 | |
BCBS
| Facility | $30.25 | $30.25 | $36.29 | |
BCBS
| Professional | $27.38 | $34.00 | $70.00 | |
Cigna
| Facility | $43.97 | $43.97 | $43.97 | |
Cigna
| Professional | $10.78 | $25.19 | $31.49 | |
United
| Professional | $9.19 | $10.19 | $24.65 |