| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $120.23 | $162.18 | $295.12 | |
Aetna
| Facility | 25 | $120.23 | $794.33 | $977.24 |
BCBS
| Facility | $186.21 | $234.42 | $588.84 | |
Cigna
| Facility | $245.47 | $478.63 | $1,380.38 | |
United
| Facility | $104.71 | $134.90 | $173.78 |