| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $208.93 | $208.93 | $208.93 | |
Aetna
| Professional | $208.93 | $208.93 | $354.81 | |
BCBS
| Professional | $208.93 | $245.47 | $245.47 | |
Cigna
| Facility | $194.98 | $194.98 | $194.98 | |
Cigna
| Professional | $208.93 | $208.93 | $295.12 | |
United
| Facility | $169.82 | $169.82 | $407.38 | |
United
| Professional | $208.93 | $208.93 | $208.93 |