| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $9.39 | $9.40 | $46.08 | |
Aetna
| Professional | $9.40 | $9.40 | $12.68 | |
AmeriHealth
| Professional | $2.75 | $2.75 | $2.75 | |
Cigna
| Professional | $8.50 | $8.50 | $8.50 | |
Horizon BCBS
| Professional | $77.19 | $90.81 | $90.81 |