| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $123.03 | $234.42 | $239.88 | |
Aetna
| Professional | $102.33 | $138.04 | $194.98 | |
Aetna
| Professional | 25 | $30.20 | $30.20 | $30.20 |
Anthem BCBS
| Professional | $1.00 | $181.97 | $208.93 | |
Cigna
| Professional | $125.89 | $186.21 | $251.19 | |
United
| Professional | $114.82 | $151.36 | $234.42 |