| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $123.80 | $126.06 | $129.99 | |
Aetna
| Professional | $123.80 | $123.80 | $136.18 | |
BCBS
| Facility | $123.80 | $123.80 | $238.93 | |
BCBS
| Professional | $123.80 | $123.80 | $126.27 | |
Cigna
| Facility | $120.29 | $123.80 | $123.80 | |
Cigna
| Professional | $123.80 | $123.80 | $145.99 | |
United
| Professional | $123.80 | $123.80 | $148.56 |