| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $218.78 | $218.78 | $316.23 | |
Aetna
| Facility | 25 | $190.55 | $275.42 | $977.24 |
Aetna
| Professional | $87.10 | $154.88 | $323.59 | |
Aetna
| Professional | 25 | $81.28 | $173.78 | $338.84 |
BCBS
| Professional | $208.93 | $257.04 | $323.59 | |
Cigna
| Facility | $169.82 | $169.82 | $186.21 | |
Cigna
| Professional | $120.23 | $204.17 | $309.03 | |
United
| Professional | $125.89 | $204.17 | $338.84 |