| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $60.00 | $60.00 | $60.00 | |
Aetna
| Professional | $20.00 | $60.00 | $71.12 | |
Cigna
| Professional | $12.50 | $40.00 | $550.58 | |
Horizon BCBS
| Professional | $63.75 | $75.00 | $75.00 | |
United
| Professional | $230.00 | $230.00 | $230.00 |