| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $85.50 | $85.50 | $85.50 | |
Aetna
| Professional | $63.50 | $75.88 | $118.61 | |
BCBS
| Facility | $120.48 | $77,999.99 | $94,999.99 | |
Cigna
| Professional | $70.36 | $70.36 | $70.36 | |
Providence
| Professional | $70.36 | $70.36 | $73.30 | |
United
| Professional | $71.98 | $71.98 | $76.44 |