| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.83 | $20.83 | $20.83 | |
Aetna
| Professional | $20.83 | $20.83 | $29.28 | |
BCBS
| Facility | $103.43 | $103.43 | $103.43 | |
BCBS
| Professional | $14.50 | $14.50 | $24.00 | |
Cigna
| Facility | $65.00 | $70.00 | $85.00 | |
Cigna
| Professional | $110.00 | $110.00 | $110.00 | |
United
| Professional | $50.00 | $50.00 | $50.00 |