| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $106.30 | $132.88 | $132.88 | |
Aetna
| Professional | $132.88 | $132.88 | $245.00 | |
BCBS
| Facility | $51.69 | $87.49 | $162.80 | |
BCBS
| Professional | $3.69 | $3.69 | $3.93 | |
Cigna
| Facility | $40.86 | $120.44 | $177.14 | |
United
| Professional | $26.83 | $26.83 | $26.83 |