| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.23 | $30.23 | $30.23 | |
Aetna
| Professional | $30.23 | $30.23 | $35.15 | |
BCBS
| Professional | $30.23 | $30.23 | $30.23 | |
Cigna
| Facility | $30.23 | $30.23 | $30.23 | |
Cigna
| Professional | $30.23 | $30.23 | $57.55 | |
United
| Professional | $26.30 | $30.23 | $36.28 |