| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $107.15 | $107.15 | $169.82 | |
Aetna
| Professional | $57.54 | $77.62 | $165.96 | |
Aetna
| Professional | 25 | $63.10 | $87.10 | $223.87 |
BCBS
| Facility | $112.20 | $186.21 | $234.42 | |
BCBS
| Professional | $7.59 | $10.00 | $120.23 | |
Cigna
| Professional | $72.44 | $131.83 | $186.21 | |
United
| Professional | $74.13 | $95.50 | $158.49 |