| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $53.95 | $53.95 | $53.95 | |
Aetna
| Professional | $52.68 | $52.68 | $53.95 | |
BCBS
| Facility | $163.19 | $163.19 | $163.19 | |
BCBS
| Professional | $49.78 | $49.78 | $49.78 | |
Cigna
| Facility | $49.67 | $53.95 | $161.62 | |
Cigna
| Professional | $53.95 | $53.95 | $53.95 | |
United
| Professional | $52.89 | $52.89 | $53.95 |