| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $77.70 | $77.70 | $77.70 | |
Aetna
| Professional | $73.81 | $78.98 | $101.37 | |
BCBS
| Professional | $65.29 | $87.05 | $87.05 | |
Cigna
| Facility | $72.52 | $72.52 | $72.52 | |
Cigna
| Professional | $72.52 | $72.52 | $72.52 | |
Providence
| Facility | $72.52 | $72.52 | $73.81 | |
Providence
| Professional | $72.52 | $72.52 | $72.52 | |
United
| Professional | $77.70 | $77.70 | $88.58 |