| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $141.25 | $141.25 | $211.88 | |
Aetna
| Professional | $141.25 | $141.25 | $155.37 | |
BCBS
| Facility | $128.75 | $128.75 | $128.75 | |
BCBS
| Professional | $128.75 | $128.75 | $128.75 | |
Cigna
| Facility | $148.50 | $148.50 | $148.50 | |
Cigna
| Professional | $148.50 | $148.50 | $148.50 | |
United
| Professional | $151.01 | $158.96 | $179.62 |