| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $137.97 | $200.60 | $298.81 | |
Aetna
| Facility | 25 | $166.88 | $207.74 | $276.75 |
Aetna
| Professional | $154.34 | $217.67 | $370.00 | |
Aetna
| Professional | 25 | $231.39 | $300.92 | $562.09 |
BCBS
| Facility | $174.37 | $268.08 | $564.58 | |
BCBS
| Professional | $173.94 | $239.52 | $404.56 | |
Cigna
| Facility | $252.50 | $252.50 | $252.50 | |
Cigna
| Professional | $186.17 | $277.36 | $442.39 | |
United
| Professional | $215.46 | $300.89 | $479.08 |