| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $120.23 | $120.23 | $120.23 | |
Aetna
| Professional | $93.33 | $138.04 | $177.83 | |
Cigna
| Professional | $141.25 | $141.25 | $141.25 | |
Horizon BCBS
| Professional | $138.04 | $138.04 | $138.04 | |
United
| Professional | $117.49 | $158.49 | $257.04 |