| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $173.60 | $173.60 | $173.60 | |
Aetna
| Professional | $121.50 | $168.94 | $196.18 | |
Cigna
| Professional | $141.06 | $141.06 | $141.06 | |
Emblem Health
| Professional | $218.98 | $218.98 | $218.98 | |
Horizon BCBS
| Professional | $168.48 | $198.21 | $203.29 | |
United
| Professional | $118.70 | $209.24 | $345.32 |