| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $31.20 | $31.20 | $31.20 | |
Aetna
| Professional | $31.20 | $39.89 | $50.44 | |
Cigna
| Facility | $58.60 | $58.60 | $91.65 | |
Cigna
| Professional | $42.78 | $42.78 | $80.25 | |
Emblem Health
| Professional | $83.73 | $84.32 | $120.06 | |
Horizon BCBS
| Professional | $89.50 | $91.65 | $91.65 | |
United
| Professional | $38.01 | $45.73 | $91.65 |