| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $213.80 | $288.40 | $602.56 | |
Aetna
| Professional | 26 | $75.86 | $89.13 | $204.17 |
Aetna
| Professional | TC | $138.04 | $169.82 | $338.84 |
BCBS
| Professional | $338.84 | $416.87 | $416.87 | |
BCBS
| Professional | 26 | $117.49 | $144.54 | $144.54 |
BCBS
| Professional | TC | $218.78 | $269.15 | $269.15 |
Cigna
| Professional | $257.04 | $407.38 | $549.54 | |
Cigna
| Professional | 26 | $91.20 | $144.54 | $194.98 |
Cigna
| Professional | TC | $165.96 | $269.15 | $380.19 |
United
| Professional | $269.15 | $436.52 | $794.33 | |
United
| Professional | 26 | $91.20 | $158.49 | $295.12 |
United
| Professional | TC | $173.78 | $288.40 | $501.19 |