| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $73.81 | $73.81 | $73.81 | |
Aetna
| Professional | $73.81 | $73.81 | $81.20 | |
BCBS
| Facility | $81.20 | $81.20 | $121.80 | |
BCBS
| Professional | $81.20 | $81.20 | $82.82 | |
Cigna
| Facility | $72.52 | $72.52 | $72.52 | |
Cigna
| Professional | $72.52 | $72.52 | $72.52 | |
United
| Professional | $66.44 | $77.70 | $92.28 |