| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $169.96 | $169.96 | $169.96 | |
BCBS
| Facility | $0.50 | $0.50 | $0.50 | |
BCBS
| Professional | $0.50 | $0.50 | $0.50 | |
Cigna
| Facility | $186.76 | $186.76 | $186.76 | |
Cigna
| Professional | $186.76 | $186.76 | $186.76 | |
United
| Professional | $0.50 | $0.50 | $199.95 |