| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $103.79 | $124.05 | $152.72 | |
Aetna
| Professional | $104.45 | $123.62 | $162.18 | |
Aetna
| Professional | 25 | $24.50 | $68.90 | $175.00 |
BCBS
| Facility | $128.55 | $155.41 | $409.33 | |
BCBS
| Professional | $103.91 | $139.56 | $208.24 | |
Cigna
| Facility | $207.65 | $207.65 | $230.37 | |
Cigna
| Professional | $124.31 | $192.86 | $252.17 | |
United
| Facility | $135.69 | $135.69 | $135.69 | |
United
| Professional | $109.83 | $148.56 | $250.82 |