| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $79.85 | $97.86 | $123.41 | |
Aetna
| Facility | 25 | $747.72 | $747.72 | $747.72 |
Aetna
| Professional | $80.39 | $109.70 | $257.60 | |
BCBS
| Facility | $105.51 | $120.09 | $316.27 | |
BCBS
| Professional | $83.03 | $114.30 | $180.53 | |
Cigna
| Facility | $135.36 | $135.36 | $135.36 | |
Cigna
| Professional | $94.47 | $137.63 | $226.57 | |
United
| Professional | $88.06 | $118.75 | $201.58 |