| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $199.39 | $199.39 | $199.39 | |
Aetna
| Professional | $94.38 | $199.39 | $199.39 | |
BCBS
| Professional | $164.54 | $164.54 | $164.54 | |
Cigna
| Facility | $144.01 | $144.01 | $211.05 | |
Cigna
| Professional | $105.13 | $144.01 | $184.80 | |
United
| Professional | $57.68 | $86.51 | $137.87 |