| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $134.90 | $154.88 | $194.98 | |
Ambetter
| Professional | $109.65 | $109.65 | $109.65 | |
Ambetter
| Professional | 25 | $112.20 | $147.91 | $173.78 |
BCBS
| Professional | $165.96 | $165.96 | $165.96 | |
Cigna
| Professional | $134.90 | $169.82 | $173.78 | |
United
| Professional | $162.18 | $173.78 | $239.88 |