| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $63.68 | $88.08 | $171.17 | |
Aetna
| Professional | $63.68 | $63.68 | $64.31 | |
Cigna
| Facility | $60.08 | $63.68 | $79.34 | |
Cigna
| Professional | $63.68 | $63.68 | $63.68 | |
Horizon BCBS
| Facility | $57.48 | $285.08 | $13,785.00 | |
Horizon BCBS
| Professional | $42.00 | $56.52 | $56.52 | |
United
| Facility | $49.81 | $49.81 | $70.13 | |
United
| Professional | $63.68 | $63.68 | $78.04 |