| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $52.00 | $52.00 | $52.00 | |
Aetna
| Professional | $52.00 | $52.00 | $52.00 | |
Cigna
| Professional | $21.25 | $21.25 | $21.25 | |
Emblem Health
| Professional | $64.05 | $79.91 | $106.75 | |
Horizon BCBS
| Professional | $47.38 | $47.38 | $47.96 | |
United
| Professional | $35.53 | $35.53 | $52.88 |