| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $190.89 | $190.89 | $190.89 | |
Aetna
| Facility | 25 | $131.63 | $131.63 | $131.63 |
Aetna
| Professional | $70.98 | $110.12 | $226.06 | |
Aetna
| Professional | 25 | $79.36 | $121.58 | $271.86 |
BCBS
| Professional | $119.00 | $146.00 | $201.00 | |
Cigna
| Facility | $170.00 | $170.00 | $185.00 | |
Cigna
| Professional | $90.66 | $140.66 | $220.45 | |
United
| Professional | $112.84 | $180.00 | $299.62 |