| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $190.55 | $190.55 | $204.17 | |
Aetna
| Facility | 25 | $117.49 | $117.49 | $204.17 |
Aetna
| Professional | $64.57 | $95.50 | $144.54 | |
BCBS
| Professional | $134.90 | $158.49 | $467.74 | |
Cigna
| Professional | $50.12 | $91.20 | $169.82 | |
MVP Health Care
| Professional | $120.23 | $177.83 | $467.74 | |
United
| Professional | $51.29 | $104.71 | $177.83 |