| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $87.45 | $99.48 | $141.74 | |
Aetna
| Professional | 26 | $67.59 | $76.08 | $109.45 |
Aetna
| Professional | TC | $19.87 | $23.40 | $32.29 |
BCBS
| Professional | $125.60 | $125.60 | $181.28 | |
BCBS
| Professional | 26 | $63.41 | $90.59 | $90.59 |
BCBS
| Professional | TC | $24.51 | $24.51 | $35.02 |
Cigna
| Professional | $86.07 | $159.15 | $218.58 | |
Cigna
| Professional | 26 | $68.81 | $112.16 | $161.81 |
Cigna
| Professional | TC | $19.80 | $46.99 | $62.94 |
United
| Professional | $89.32 | $104.18 | $154.51 | |
United
| Professional | 26 | $66.12 | $84.10 | $114.38 |
United
| Professional | TC | $18.02 | $27.41 | $40.13 |