| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $16.20 | $114.86 | $402.90 | |
Aetna
| Facility | 25 | $453.53 | $453.53 | $453.53 |
Aetna
| Professional | $103.37 | $120.56 | $159.00 | |
Ambetter
| Professional | $117.99 | $123.89 | $178.04 | |
BCBS
| Professional | $78.50 | $131.13 | $162.24 | |
Cigna
| Professional | $103.49 | $153.44 | $258.56 | |
United
| Professional | $98.27 | $126.35 | $175.22 |