| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $29.98 | $29.98 | $29.98 | |
Aetna
| Professional | $11.34 | $11.34 | $29.98 | |
Cigna
| Professional | $17.84 | $17.84 | $17.84 | |
Horizon BCBS
| Professional | $21.26 | $25.01 | $25.01 | |
United
| Professional | $20.75 | $43.46 | $63.16 |