| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $16.98 | $16.98 | $16.98 | |
Aetna
| Professional | $16.98 | $16.98 | $16.98 | |
Cigna
| Facility | $64.57 | $64.57 | $64.57 | |
Horizon BCBS
| Facility | $91.20 | $138.04 | $223.87 | |
United
| Facility | $100.00 | $181.97 | $218.78 |