| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.00 | $25.00 | $25.00 | |
Aetna
| Professional | $25.00 | $25.00 | $25.00 | |
BCBS
| Facility | $26.86 | $26.86 | $61.54 | |
BCBS
| Professional | $26.86 | $26.86 | $26.86 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $7.65 | $7.65 | $30.75 | |
United
| Professional | $43.87 | $43.87 | $43.87 |