| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $256.10 | $256.10 | $256.10 | |
Aetna
| Professional | $78.80 | $78.80 | $81.95 | |
BCBS
| Facility | $81.70 | $81.70 | $116.08 | |
BCBS
| Professional | $78.80 | $78.80 | $78.80 | |
Cigna
| Facility | $74.33 | $78.79 | $78.79 | |
Cigna
| Professional | $78.79 | $78.79 | $78.79 | |
United
| Professional | $78.80 | $78.80 | $88.26 |