| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $125.89 | $125.89 | $162.18 | |
Aetna
| Professional | $87.10 | $87.10 | $398.11 | |
Ambetter
| Professional | $21.38 | $79.43 | $89.13 | |
BCBS
| Professional | $234.42 | $257.04 | $338.84 | |
Cigna
| Professional | $257.04 | $257.04 | $257.04 | |
Qualchoice
| Professional | $24.55 | $24.55 | $102.33 |