| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $112.45 | $112.45 | $114.48 | |
Aetna
| Professional | $112.45 | $113.57 | $124.93 | |
BCBS
| Facility | $212.41 | $257.77 | $346.78 | |
BCBS
| Professional | $112.45 | $112.45 | $112.45 | |
Cigna
| Facility | $112.45 | $112.45 | $112.45 | |
Cigna
| Professional | $112.45 | $112.45 | $284.00 | |
United
| Professional | $112.45 | $112.45 | $112.45 |