| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $126.07 | $126.07 | $126.07 | |
Aetna
| Professional | $96.72 | $103.52 | $126.07 | |
Cigna
| Professional | $58.65 | $58.65 | $58.65 | |
Horizon BCBS
| Professional | $140.40 | $140.40 | $140.40 |