| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $47.50 | $60.00 | $340.00 | |
Aetna
| Professional | 26 | $8.44 | $98.80 | $340.00 |
Aetna
| Professional | TC | $54.73 | $54.73 | $54.73 |
BCBS
| Professional | $39.99 | $61.00 | $96.00 | |
BCBS
| Professional | 26 | $8.65 | $13.00 | $21.00 |
BCBS
| Professional | TC | $31.34 | $48.00 | $75.00 |
Cigna
| Professional | $16.17 | $52.98 | $136.31 | |
Cigna
| Professional | 26 | $3.61 | $10.51 | $29.18 |
Cigna
| Professional | TC | $12.55 | $42.47 | $107.13 |
United
| Professional | $18.84 | $62.80 | $134.40 | |
United
| Professional | 26 | $4.33 | $4.33 | $30.90 |
United
| Professional | TC | $14.51 | $48.36 | $103.50 |