| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $12.49 | $12.49 | $12.49 | |
Aetna
| Professional | $12.49 | $12.49 | $14.36 | |
BCBS
| Professional | $12.49 | $12.49 | $12.49 | |
Cigna
| Facility | $12.49 | $12.49 | $12.49 | |
Cigna
| Professional | $12.49 | $12.49 | $18.05 | |
United
| Professional | $10.62 | $12.49 | $12.49 |