| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $93.75 | $93.75 | $131.25 | |
Aetna
| Professional | $93.75 | $93.75 | $93.75 | |
BCBS
| Facility | $89.06 | $115.89 | $135.21 | |
BCBS
| Professional | $89.06 | $89.06 | $90.84 | |
Cigna
| Facility | $79.50 | $79.50 | $79.50 | |
Cigna
| Professional | $79.50 | $79.50 | $79.50 | |
United
| Professional | $90.69 | $90.69 | $113.36 |