| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.00 | $25.00 | $30.00 | |
Aetna
| Professional | $25.00 | $25.00 | $25.00 | |
Anthem BCBS
| Professional | $23.80 | $23.80 | $23.80 | |
Cigna
| Facility | $32.74 | $32.74 | $32.74 | |
Cigna
| Professional | $23.90 | $23.90 | $32.74 | |
Harvard Pilgrim
| Professional | $128.79 | $128.79 | $397.51 | |
United
| Professional | $28.80 | $28.80 | $128.79 |