| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $66.42 | $96.56 | $143.69 | |
Aetna
| Facility | 25 | $411.50 | $411.50 | $411.50 |
Aetna
| Professional | $74.43 | $103.31 | $148.84 | |
Ambetter
| Professional | $74.44 | $90.17 | $120.22 | |
BCBS
| Professional | $57.84 | $93.49 | $106.44 | |
Cigna
| Professional | $74.09 | $113.33 | $195.79 | |
United
| Professional | $72.76 | $88.73 | $125.45 |