| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.53 | $40.53 | $40.53 | |
Aetna
| Professional | $11.19 | $14.04 | $52.38 | |
Aetna
| Professional | 25 | $18.01 | $18.01 | $18.01 |
BCBS
| Professional | $17.00 | $21.00 | $26.00 | |
Cigna
| Professional | $12.07 | $20.34 | $28.92 | |
United
| Professional | $15.48 | $25.80 | $37.25 |