| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $189.30 | $189.30 | $189.30 | |
Aetna
| Professional | $114.79 | $189.30 | $233.71 | |
Cigna
| Professional | $191.36 | $191.36 | $191.36 | |
Horizon BCBS
| Professional | $208.60 | $208.60 | $208.60 | |
United
| Professional | $175.58 | $216.59 | $404.37 |