| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $66.12 | $66.12 | $66.12 | |
Aetna
| Professional | $66.12 | $79.31 | $155.40 | |
Ambetter
| Professional | $103.19 | $103.19 | $103.19 | |
BCBS
| Professional | $95.99 | $109.15 | $153.41 | |
Cigna
| Professional | $73.14 | $73.14 | $73.14 | |
Medcost
| Facility | $66.12 | $75.92 | $129.19 | |
United
| Professional | $80.75 | $118.44 | $191.98 |