| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $53.40 | $57.51 | $57.51 | |
Aetna
| Professional | $57.51 | $57.51 | $69.01 | |
BCBS
| Professional | $57.51 | $57.51 | $57.51 | |
Cigna
| Facility | $57.51 | $57.51 | $57.51 | |
Cigna
| Professional | $57.51 | $57.51 | $57.51 | |
United
| Professional | $46.01 | $57.51 | $57.51 |