| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $311.68 | $311.68 | $311.68 | |
Aetna
| Professional | $95.90 | $95.90 | $100.70 | |
BCBS
| Facility | $108.03 | $108.03 | $204.00 | |
BCBS
| Professional | $95.90 | $95.90 | $95.90 | |
Cigna
| Facility | $95.90 | $95.90 | $95.90 | |
Cigna
| Professional | $95.90 | $95.90 | $169.69 | |
United
| Professional | $95.90 | $95.90 | $106.76 |