| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $190.55 | $190.55 | $190.55 | |
Aetna
| Professional | $190.55 | $190.55 | $190.55 | |
BCBS
| Facility | $131.83 | $131.83 | $131.83 | |
BCBS
| Professional | $131.83 | $131.83 | $131.83 | |
Cigna
| Facility | $190.55 | $190.55 | $190.55 | |
Cigna
| Professional | $190.55 | $190.55 | $190.55 | |
United
| Facility | $169.82 | $169.82 | $181.97 | |
United
| Professional | $169.82 | $190.55 | $204.17 |