| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.59 | $39.28 | $72.37 | |
Aetna
| Professional | $25.59 | $25.59 | $25.85 | |
Cigna
| Facility | $25.59 | $28.49 | $36.86 | |
Cigna
| Professional | $25.59 | $25.59 | $25.59 | |
Horizon BCBS
| Facility | $23.62 | $13,785.00 | $13,785.00 | |
Horizon BCBS
| Professional | $28.91 | $28.91 | $33.27 | |
United
| Professional | $25.59 | $25.59 | $35.81 |