| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $58.59 | $65.47 | $83.21 | |
Aetna
| Professional | 25 | $1.53 | $67.70 | $79.90 |
Ambetter
| Professional | $71.84 | $77.34 | $94.00 | |
Ambetter
| Professional | 25 | $71.79 | $78.45 | $95.72 |
BCBS
| Facility | $128.90 | $149.82 | $162.80 | |
BCBS
| Professional | $59.49 | $83.64 | $97.77 | |
Cigna
| Professional | $68.33 | $102.33 | $266.70 | |
United
| Professional | $62.11 | $76.81 | $112.80 | |
United
| Professional | 25 | $99.10 | $99.10 | $99.10 |