| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $29.51 | $109.65 | $9,332.54 | |
Aetna
| Facility | 25 | $407.38 | $407.38 | $407.38 |
Aetna
| Professional | $64.57 | $107.15 | $204.17 | |
Ambetter
| Professional | $67.61 | $83.18 | $112.20 | |
BCBS
| Professional | $67.61 | $93.33 | $107.15 | |
Cigna
| Professional | $74.13 | $112.20 | $194.98 | |
United
| Professional | $67.61 | $89.13 | $134.90 |