| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.10 | $40.10 | $40.10 | |
Aetna
| Professional | $40.10 | $49.21 | $71.26 | |
Cigna
| Facility | $70.70 | $70.70 | $113.11 | |
Cigna
| Professional | $51.62 | $51.62 | $99.04 | |
Emblem Health
| Professional | $103.32 | $104.06 | $148.16 | |
Horizon BCBS
| Professional | $110.46 | $113.11 | $113.11 | |
United
| Professional | $51.16 | $56.42 | $113.11 |