| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $63.10 | $162.18 | $446.68 | |
Aetna
| Facility | 25 | $52.48 | $223.87 | $223.87 |
Aetna
| Professional | $26.92 | $50.12 | $100.00 | |
Aetna
| Professional | 25 | $32.36 | $56.23 | $102.33 |
BCBS
| Professional | $51.29 | $63.10 | $102.33 | |
Cigna
| Facility | $169.82 | $169.82 | $186.21 | |
Cigna
| Professional | $30.90 | $53.70 | $93.33 | |
United
| Professional | $30.20 | $53.70 | $102.33 |