| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22.96 | $25.50 | $25.50 | |
Aetna
| Professional | $22.96 | $25.58 | $58.48 | |
Cigna
| Facility | $225.00 | $225.00 | $225.00 | |
Cigna
| Professional | $44.92 | $56.91 | $56.91 | |
Horizon BCBS
| Professional | $46.27 | $46.27 | $46.27 | |
United
| Professional | $29.75 | $34.70 | $76.76 |