| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $13.92 | $383.00 | $1,381.00 | |
Aetna
| Facility | 25 | $87.77 | $324.00 | $2,344.00 |
Cigna
| Facility | $315.00 | $400.00 | $421.00 | |
Horizon BCBS
| Facility | $214.08 | $214.08 | $214.08 |