| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $67.61 | $67.61 | $67.61 | |
Aetna
| Professional | $54.95 | $72.44 | $117.49 | |
Aetna
| Professional | 25 | $14.45 | $14.45 | $69.18 |
BCBS
| Facility | $131.83 | $158.49 | $177.83 | |
BCBS
| Professional | $53.70 | $63.10 | $107.15 | |
Cigna
| Professional | $107.15 | $107.15 | $177.83 | |
United
| Professional | $58.88 | $72.44 | $107.15 |