| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | 26 | $191.12 | $191.12 | $349.87 |
Aetna
| Professional | $267.81 | $366.92 | $366.92 | |
Aetna
| Professional | 26 | $106.23 | $112.50 | $266.77 |
Aetna
| Professional | TC | $161.58 | $254.42 | $254.42 |
BCBS
| Professional | $429.77 | $429.77 | $765.71 | |
BCBS
| Professional | 26 | $97.28 | $138.97 | $197.25 |
BCBS
| Professional | TC | $203.56 | $247.18 | $290.80 |
Cigna
| Professional | $229.97 | $262.42 | $753.52 | |
Cigna
| Professional | 26 | $1.49 | $199.25 | $246.84 |
Cigna
| Professional | TC | $3.34 | $177.10 | $522.46 |
United
| Professional | $127.30 | $445.92 | $641.75 | |
United
| Professional | 26 | $63.05 | $157.51 | $238.19 |
United
| Professional | TC | $65.31 | $288.41 | $403.56 |