| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $251.07 | $536.00 | $879.74 | |
Aetna
| Professional | $314.18 | $315.66 | $450.36 | |
AmeriHealth
| Facility | $1,562.40 | $1,562.40 | $1,562.40 | |
Cigna
| Facility | $130.37 | $2,736.98 | $3,087.43 | |
Cigna
| Professional | $52.02 | $52.02 | $52.02 | |
Horizon BCBS
| Facility | $868.25 | $868.25 | $868.25 |