| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $75.76 | $75.76 | $120.75 | |
Aetna
| Professional | $75.76 | $93.44 | $120.75 | |
BCBS
| Facility | $104.77 | $104.77 | $104.77 | |
BCBS
| Professional | $104.77 | $104.77 | $104.77 | |
Cigna
| Facility | $112.36 | $112.36 | $112.36 | |
Cigna
| Professional | $82.02 | $82.02 | $112.36 | |
United
| Professional | $44.96 | $64.18 | $103.93 |