| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $15.00 | $15.00 | $15.00 | |
Aetna
| Professional | $15.00 | $15.00 | $15.00 | |
Cigna
| Professional | $1.68 | $1.68 | $1.68 | |
Horizon BCBS
| Professional | $42.50 | $50.00 | $50.00 | |
United
| Professional | $6.24 | $6.24 | $6.24 |