| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $66.07 | $66.07 | $100.00 | |
Aetna
| Professional | $50.12 | $66.07 | $109.65 | |
Ambetter
| Professional | $19.50 | $52.48 | $61.66 | |
BCBS
| Facility | $64.57 | $64.57 | $64.57 | |
BCBS
| Professional | $64.57 | $64.57 | $64.57 | |
Cigna
| Facility | $61.66 | $70.79 | $70.79 | |
Cigna
| Professional | $70.79 | $70.79 | $70.79 | |
United
| Professional | $61.66 | $67.61 | $79.43 |