| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $12.83 | $12.83 | $12.83 | |
Aetna
| Professional | $12.62 | $12.83 | $24.74 | |
BCBS
| Professional | $14.00 | $14.00 | $14.00 | |
Cigna
| Facility | $30.15 | $30.15 | $30.15 | |
Cigna
| Professional | $30.15 | $30.15 | $56.20 | |
United
| Professional | $17.50 | $17.50 | $17.50 |