| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $85.14 | $94.57 | $94.57 | |
Aetna
| Professional | $85.14 | $94.87 | $216.80 | |
Cigna
| Facility | $225.00 | $225.00 | $225.00 | |
Cigna
| Professional | $119.00 | $119.00 | $166.72 | |
Horizon BCBS
| Professional | $171.55 | $171.55 | $171.55 | |
United
| Professional | $121.33 | $144.44 | $344.94 |