| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $398.11 | $398.11 | $398.11 | |
Aetna
| Professional | $87.10 | $87.10 | $398.11 | |
Ambetter
| Professional | $46.77 | $46.77 | $46.77 | |
Cigna
| Professional | $275.42 | $288.40 | $870.96 | |
Horizon BCBS
| Professional | $138.04 | $162.18 | $162.18 | |
United
| Professional | $165.96 | $363.08 | $380.19 |