| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $167.90 | $167.90 | $167.90 | |
Aetna
| Professional | $120.17 | $167.90 | $198.24 | |
BCBS
| Professional | $142.00 | $142.00 | $142.00 | |
Cigna
| Professional | $94.26 | $94.26 | $94.26 | |
United
| Professional | $65.31 | $97.97 | $158.81 |