| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.23 | $21.23 | $21.23 | |
Aetna
| Professional | $21.23 | $21.23 | $22.29 | |
BCBS
| Facility | $198.03 | $240.32 | $323.31 | |
BCBS
| Professional | $27.66 | $27.66 | $27.66 | |
Cigna
| Facility | $28.21 | $28.21 | $28.21 | |
Cigna
| Professional | $28.21 | $28.21 | $41.92 | |
United
| Professional | $21.23 | $21.23 | $21.23 |