| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $110.01 | $122.21 | $122.21 | |
Aetna
| Professional | $110.01 | $122.59 | $280.12 | |
Cigna
| Facility | $225.00 | $225.00 | $225.00 | |
Cigna
| Professional | $153.00 | $153.00 | $215.34 | |
Horizon BCBS
| Professional | $221.66 | $221.66 | $221.66 | |
United
| Professional | $142.57 | $172.90 | $445.69 |