| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $84.91 | $84.91 | $85.33 | |
Aetna
| Professional | $54.33 | $71.53 | $85.54 | |
Aetna
| Professional | 25 | $183.48 | $183.48 | $183.48 |
BCBS
| Facility | $148.35 | $165.11 | $165.11 | |
BCBS
| Professional | $59.29 | $85.11 | $121.74 | |
Cigna
| Professional | $67.86 | $97.20 | $150.88 | |
United
| Professional | $70.59 | $88.28 | $125.49 | |
United
| Professional | 25 | $94.07 | $94.07 | $94.07 |