| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $137.06 | $188.37 | $356.53 | |
AmeriHealth
| Professional | $527.00 | $527.00 | $527.00 | |
Cigna
| Facility | $209.52 | $209.52 | $290.14 | |
Cigna
| Professional | $178.09 | $209.52 | $517.50 | |
Emblem Health
| Professional | $497.10 | $497.10 | $497.10 | |
Horizon BCBS
| Professional | $286.39 | $286.39 | $286.39 | |
United
| Professional | $189.90 | $214.80 | $266.37 |