| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $112.89 | $114.03 | $114.03 | |
Aetna
| Professional | 26 | $78.68 | $79.65 | $79.65 |
Aetna
| Professional | TC | $34.21 | $34.38 | $34.38 |
BCBS
| Professional | $155.00 | $192.00 | $192.00 | |
BCBS
| Professional | 26 | $110.00 | $136.00 | $136.00 |
BCBS
| Professional | TC | $45.00 | $56.00 | $56.00 |
Cigna
| Professional | $82.58 | $119.45 | $149.36 | |
Cigna
| Professional | 26 | $63.13 | $100.57 | $116.59 |
Cigna
| Professional | TC | $17.82 | $22.60 | $32.78 |
United
| Professional | $105.20 | $158.08 | $197.26 | |
United
| Professional | 26 | $81.36 | $131.08 | $162.00 |
United
| Professional | TC | $20.16 | $35.19 | $48.36 |