| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $125.20 | $125.20 | $125.20 | |
Aetna
| Professional | $60.04 | $84.95 | $125.20 | |
AmeriHealth
| Professional | $210.00 | $210.00 | $210.00 | |
Cigna
| Professional | $8.89 | $59.00 | $246.71 | |
Horizon BCBS
| Professional | $119.21 | $140.25 | $140.25 | |
United
| Professional | $320.00 | $320.00 | $320.00 |