| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $26.00 | $26.00 | $26.00 | |
Capital Blue Cross
| Facility | $1.49 | $1.75 | $8,459.92 | |
Capital Blue Cross
| Professional | $1.75 | $1.75 | $1.75 | |
Cigna
| Professional | $1.12 | $1.12 | $1.41 | |
Priority Health
| Professional | $1.12 | $1.12 | $1.41 | |
United
| Professional | $0.27 | $0.68 | $1.24 |