| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $145.10 | $164.83 | $190.97 | |
Aetna
| Professional | $130.50 | $160.38 | $192.47 | |
Aetna
| Professional | 25 | $231.00 | $231.00 | $231.00 |
BCBS
| Facility | $0.02 | $0.03 | $0.03 | |
BCBS
| Professional | $184.01 | $188.53 | $221.28 | |
Christus
| Facility | $169.90 | $169.90 | $169.90 | |
Cigna
| Professional | $152.62 | $172.85 | $304.95 | |
United
| Professional | $108.61 | $165.34 | $244.76 |