| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $71.59 | $71.59 | $71.59 | |
Aetna
| Professional | $69.12 | $71.92 | $153.00 | |
Ambetter
| Professional | $29.33 | $34.50 | $139.61 | |
Cigna
| Professional | $20.93 | $20.93 | $20.93 | |
Qualchoice
| Professional | $33.72 | $39.68 | $160.55 |