| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $206.96 | $206.96 | $206.96 | |
Aetna
| Professional | $63.68 | $63.68 | $66.23 | |
BCBS
| Facility | $62.47 | $62.47 | $113.87 | |
BCBS
| Professional | $63.68 | $63.68 | $63.68 | |
Cigna
| Facility | $60.08 | $63.68 | $63.68 | |
Cigna
| Professional | $63.68 | $63.68 | $63.68 | |
United
| Professional | $63.68 | $63.68 | $71.31 |