| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $45.40 | $96.05 | $125.00 | |
Aetna
| Professional | $74.02 | $74.73 | $87.35 | |
Ambetter
| Professional | $28.76 | $28.76 | $33.84 | |
Cigna
| Professional | $87.12 | $87.12 | $87.12 | |
Qualchoice
| Professional | $38.92 | $38.92 | $148.01 |