| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $173.00 | $173.00 | $173.00 | |
Aetna
| Professional | $173.00 | $173.00 | $173.00 | |
BCBS
| Professional | $160.09 | $172.46 | $172.46 | |
Cigna
| Facility | $263.02 | $263.02 | $263.02 | |
Cigna
| Professional | $192.01 | $263.02 | $263.02 | |
Medcost
| Facility | $173.00 | $173.00 | $207.60 | |
United
| Professional | $93.21 | $93.21 | $93.21 | |
Wellcare
| Facility | $100.00 | $161.19 | $161.19 |