| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $110.46 | $110.46 | $110.46 | |
Aetna
| Professional | $79.06 | $110.46 | $130.43 | |
BCBS
| Professional | $94.00 | $94.00 | $94.00 | |
Cigna
| Professional | $62.01 | $62.01 | $62.01 | |
United
| Professional | $42.97 | $68.95 | $104.49 |