| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $213.30 | $213.30 | $213.30 | |
Aetna
| Professional | $65.63 | $65.63 | $68.25 | |
BCBS
| Facility | $65.25 | $65.73 | $69.45 | |
BCBS
| Professional | $65.63 | $65.63 | $65.63 | |
Cigna
| Facility | $61.91 | $65.63 | $65.63 | |
Cigna
| Professional | $65.63 | $65.63 | $65.63 | |
United
| Professional | $65.63 | $65.63 | $65.63 |