| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $51.12 | $51.12 | $51.12 | |
Aetna
| Professional | $51.12 | $51.12 | $51.12 | |
BCBS
| Facility | $76.87 | $79.83 | $79.83 | |
Cigna
| Facility | $83.26 | $83.26 | $83.26 | |
United
| Facility | $55.50 | $55.50 | $55.50 |