| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $97.11 | $118.27 | $143.33 | |
Aetna
| Professional | $101.27 | $121.83 | $143.33 | |
Aetna
| Professional | 25 | $118.00 | $125.07 | $170.23 |
BCBS
| Facility | $92.03 | $92.03 | $92.03 | |
BCBS
| Professional | $140.31 | $140.31 | $152.46 | |
Cigna
| Professional | $108.71 | $108.71 | $173.14 | |
Molina
| Professional | $32.34 | $32.34 | $32.34 | |
United
| Professional | $85.19 | $127.72 | $164.14 |