| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $72.65 | $72.65 | $4,375.00 | |
Aetna
| Professional | $14.82 | $63.74 | $139.75 | |
Cigna
| Professional | $130.77 | $130.77 | $130.77 | |
Horizon BCBS
| Facility | $138.40 | $151.02 | $311.98 |