| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $80.77 | $80.77 | $80.77 | |
Aetna
| Professional | $30.36 | $66.16 | $80.77 | |
Cigna
| Professional | $38.77 | $38.77 | $38.77 | |
Emblem Health
| Professional | $99.77 | $124.48 | $166.29 | |
Horizon BCBS
| Professional | $61.62 | $61.62 | $61.62 | |
United
| Professional | $41.15 | $47.40 | $63.21 |