| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $121.93 | $121.93 | $121.93 | |
Aetna
| Professional | $57.72 | $121.93 | $121.93 | |
BCBS
| Professional | $100.62 | $100.62 | $100.62 | |
Cigna
| Facility | $112.36 | $112.36 | $166.73 | |
Cigna
| Professional | $82.02 | $112.36 | $145.99 | |
United
| Professional | $44.96 | $66.84 | $101.60 |