| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $109.65 | $109.65 | $109.65 | |
Aetna
| Professional | $54.95 | $56.23 | $63.10 | |
BCBS
| Facility | $54.95 | $54.95 | $58.88 | |
BCBS
| Professional | $54.95 | $54.95 | $54.95 | |
Cigna
| Facility | $52.48 | $54.95 | $54.95 | |
Cigna
| Professional | $54.95 | $54.95 | $54.95 | |
United
| Facility | $0.54 | $0.54 | $0.54 | |
United
| Professional | $21.88 | $54.95 | $54.95 |