| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $69.73 | $69.73 | $82.37 | |
Aetna
| Professional | $69.73 | $69.73 | $83.67 | |
BCBS
| Facility | $111.43 | $135.22 | $181.92 | |
BCBS
| Professional | $69.73 | $69.73 | $83.25 | |
Cigna
| Facility | $69.73 | $69.73 | $69.73 | |
Cigna
| Professional | $69.73 | $81.00 | $153.43 | |
United
| Professional | $27.89 | $69.73 | $69.73 |