| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $157.99 | $157.99 | $157.99 | |
Aetna
| Professional | $157.99 | $195.50 | $261.29 | |
Cigna
| Facility | $273.20 | $273.20 | $464.11 | |
Cigna
| Professional | $199.44 | $199.44 | $406.38 | |
Emblem Health
| Professional | $423.98 | $426.98 | $607.98 | |
Horizon BCBS
| Professional | $453.23 | $464.11 | $464.11 | |
United
| Professional | $186.43 | $231.53 | $464.11 |