| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $99.11 | $99.11 | $99.11 | |
Aetna
| Professional | $99.11 | $102.54 | $122.42 | |
Ambetter
| Professional | $78.20 | $130.00 | $130.00 | |
Cigna
| Professional | $9.85 | $9.85 | $9.85 | |
Horizon BCBS
| Professional | $95.63 | $112.50 | $112.50 |