| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $363.08 | $363.08 | $363.08 | |
Aetna
| Professional | $3.98 | $9.55 | $74.13 | |
BCBS
| Facility | $114.82 | $131.83 | $162.18 | |
BCBS
| Professional | $4.07 | $28.84 | $74.13 | |
Cigna
| Professional | $50.12 | $50.12 | $50.12 | |
United
| Professional | $5.62 | $43.65 | $95.50 |