| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $169.82 | $169.82 | $169.82 | |
Aetna
| Professional | $169.82 | $169.82 | $288.40 | |
Anthem BCBS
| Professional | $380.19 | $380.19 | $389.05 | |
Cigna
| Professional | $426.58 | $426.58 | $426.58 | |
United
| Facility | $338.84 | $338.84 | $338.84 | |
United
| Professional | $707.95 | $707.95 | $707.95 |