| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $104.71 | $104.71 | $104.71 | |
Aetna
| Professional | $104.71 | $104.71 | $177.83 | |
BCBS
| Professional | $489.78 | $575.44 | $575.44 | |
Cigna
| Facility | $97.72 | $97.72 | $97.72 | |
Cigna
| Professional | $104.71 | $104.71 | $147.91 | |
United
| Facility | $169.82 | $169.82 | $977.24 | |
United
| Professional | $104.71 | $104.71 | $104.71 |