| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $35.00 | $35.00 | $35.00 | |
Aetna
| Professional | $35.00 | $35.00 | $35.00 | |
BCBS
| Facility | $29.70 | $29.70 | $29.70 | |
BCBS
| Professional | $12.38 | $20.26 | $20.26 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $59.40 | $59.40 | $59.40 | |
United
| Professional | $37.62 | $37.62 | $37.62 |