| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $119.61 | $119.61 | $119.61 | |
BCBS
| Facility | $0.50 | $0.50 | $0.50 | |
BCBS
| Professional | $0.50 | $0.50 | $0.50 | |
Cigna
| Facility | $131.35 | $131.35 | $131.35 | |
Cigna
| Professional | $131.35 | $131.35 | $131.35 | |
United
| Professional | $47.00 | $117.28 | $140.74 |