| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $159.63 | $159.63 | $163.99 | |
Aetna
| Professional | $136.37 | $165.28 | $198.82 | |
Aetna
| Professional | 25 | $168.77 | $168.77 | $182.00 |
BCBS
| Professional | $242.00 | $298.00 | $298.00 | |
Cigna
| Professional | $147.60 | $147.60 | $163.96 | |
United
| Professional | $201.18 | $301.77 | $441.36 |