| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $124.44 | $124.44 | $124.44 | |
Aetna
| Professional | $58.90 | $124.44 | $124.44 | |
BCBS
| Professional | $64.54 | $64.54 | $64.54 | |
Cigna
| Facility | $86.21 | $86.21 | $155.65 | |
Cigna
| Professional | $62.93 | $86.21 | $136.29 | |
United
| Professional | $45.89 | $68.83 | $103.69 |