| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $61.28 | $79.91 | $637.50 | |
Aetna
| Professional | 26 | $14.20 | $212.00 | $316.20 |
Aetna
| Professional | TC | $65.72 | $65.72 | $65.72 |
BCBS
| Professional | $52.64 | $80.00 | $126.00 | |
BCBS
| Professional | 26 | $22.00 | $34.00 | $34.00 |
BCBS
| Professional | TC | $58.00 | $92.00 | $92.00 |
Cigna
| Professional | $22.96 | $68.43 | $178.97 | |
Cigna
| Professional | 26 | $5.94 | $17.44 | $48.30 |
Cigna
| Professional | TC | $17.02 | $50.99 | $130.66 |
United
| Professional | $25.12 | $83.72 | $168.00 | |
United
| Professional | 26 | $7.15 | $22.36 | $30.00 |
United
| Professional | TC | $17.97 | $59.90 | $138.00 |