| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $77.22 | $104.92 | $166.40 | |
Aetna
| Facility | 25 | $229.84 | $487.28 | $1,556.00 |
Aetna
| Professional | $63.66 | $107.43 | $200.34 | |
BCBS
| Facility | $97.63 | $115.21 | $303.41 | |
BCBS
| Professional | $75.47 | $107.16 | $159.50 | |
Cigna
| Facility | $94.44 | $94.44 | $94.44 | |
Cigna
| Professional | $78.62 | $119.67 | $205.07 | |
United
| Professional | $82.13 | $109.66 | $190.89 |