| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $199.50 | $249.00 | $510.00 | |
Aetna
| Professional | 26 | $103.87 | $349.60 | $797.30 |
Aetna
| Professional | TC | $171.22 | $171.22 | $171.22 |
BCBS
| Professional | $362.34 | $551.00 | $870.00 | |
BCBS
| Professional | 26 | $158.00 | $250.00 | $250.00 |
BCBS
| Professional | TC | $393.00 | $620.00 | $620.00 |
Cigna
| Professional | $153.19 | $459.19 | $1,233.57 | |
Cigna
| Professional | 26 | $42.98 | $125.81 | $349.11 |
Cigna
| Professional | TC | $110.20 | $333.38 | $884.46 |
United
| Professional | $168.90 | $563.00 | $585.58 | |
United
| Professional | 26 | $51.97 | $161.97 | $218.00 |
United
| Professional | TC | $116.93 | $116.93 | $423.60 |