| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $75.61 | $118.34 | $155.00 | |
Aetna
| Professional | 25 | $114.88 | $114.88 | $114.88 |
Ambetter
| Professional | $131.57 | $140.71 | $177.62 | |
Ambetter
| Professional | 25 | $98.50 | $98.50 | $98.50 |
BCBS
| Professional | $75.56 | $117.10 | $128.81 | |
Cigna
| Professional | $61.09 | $100.45 | $182.10 | |
United
| Professional | $91.60 | $126.71 | $160.29 |