| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $87.10 | $87.10 | $87.10 | |
Aetna
| Professional | $87.10 | $87.10 | $147.91 | |
BCBS
| Professional | $91.20 | $107.15 | $107.15 | |
Cigna
| Facility | $83.18 | $83.18 | $83.18 | |
Cigna
| Professional | $87.10 | $87.10 | $123.03 | |
United
| Facility | $87.10 | $87.10 | $87.10 | |
United
| Professional | $87.10 | $87.10 | $87.10 |