| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $217.09 | $217.09 | $217.09 | |
Aetna
| Professional | $217.09 | $217.09 | $238.80 | |
BCBS
| Professional | $214.10 | $251.88 | $251.88 | |
Cigna
| Facility | $204.80 | $204.80 | $204.80 | |
Cigna
| Professional | $217.09 | $266.24 | $307.20 | |
United
| Professional | $217.09 | $217.09 | $217.09 |