| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $52.48 | $52.48 | $52.48 | |
Aetna
| Professional | $47.86 | $47.86 | $162.18 | |
AmeriHealth
| Professional | $177.83 | $177.83 | $177.83 | |
Cigna
| Professional | $165.96 | $426.58 | $758.58 | |
Horizon BCBS
| Professional | $181.97 | $181.97 | $213.80 | |
United
| Professional | $151.36 | $190.55 | $537.03 |