| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $112.20 | $112.20 | $495.00 | |
Aetna
| Professional | $3.44 | $3.44 | $112.20 | |
Cigna
| Professional | $119.56 | $119.56 | $119.56 | |
Emblem Health
| Professional | $38,249.62 | $38,249.62 | $38,249.62 | |
Horizon BCBS
| Facility | $132.90 | $160.97 | $187.24 | |
United
| Facility | $153.87 | $278.22 | $335.48 |