| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $104.37 | $130.00 | $227.59 | |
Aetna
| Facility | 25 | $398.40 | $499.20 | $499.20 |
Aetna
| Professional | $101.39 | $139.84 | $301.48 | |
BCBS
| Facility | $139.44 | $156.57 | $412.35 | |
BCBS
| Professional | $111.82 | $147.11 | $227.90 | |
Cigna
| Facility | $149.03 | $149.03 | $149.03 | |
Cigna
| Professional | $119.83 | $173.14 | $276.68 | |
United
| Professional | $117.97 | $151.26 | $263.57 |