| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $125.82 | $129.43 | $367.07 | |
Aetna
| Professional | $42.86 | $129.02 | $154.97 | |
Aetna
| Professional | 25 | $2.67 | $137.66 | $166.99 |
BCBS
| Professional | $190.00 | $234.00 | $234.00 | |
Cigna
| Professional | $116.36 | $116.36 | $129.02 | |
United
| Professional | $136.50 | $204.75 | $292.50 |