| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $107.63 | $107.63 | $171.53 | |
Aetna
| Professional | $102.50 | $122.76 | $171.53 | |
Ambetter
| Professional | $100.00 | $100.00 | $144.04 | |
BCBS
| Facility | $148.84 | $148.84 | $148.84 | |
BCBS
| Professional | $148.84 | $148.84 | $148.84 | |
Cigna
| Facility | $106.63 | $106.63 | $121.71 | |
Cigna
| Professional | $77.84 | $77.84 | $121.71 | |
United
| Professional | $56.76 | $91.18 | $143.03 |