| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $57.54 | $100.00 | $269.15 | |
Aetna
| Professional | 25 | $117.49 | $117.49 | $117.49 |
Ambetter
| Professional | $46.77 | $54.95 | $79.43 | |
BCBS
| Professional | $48.98 | $64.57 | $95.50 | |
Cigna
| Professional | $64.57 | $77.62 | $120.23 | |
Molina
| Professional | $32.36 | $32.36 | $33.11 | |
United
| Professional | $61.66 | $75.86 | $114.82 |