| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $400.00 | $400.00 | $400.00 | |
Aetna
| Professional | $87.57 | $125.82 | $400.00 | |
Cigna
| Professional | $12.00 | $274.00 | $868.63 | |
Horizon BCBS
| Professional | $137.55 | $161.82 | $161.82 | |
United
| Professional | $367.00 | $367.00 | $367.00 |