| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $83.75 | $83.75 | $83.75 | |
Aetna
| Professional | $25.76 | $25.77 | $26.80 | |
BCBS
| Facility | $20.63 | $23.93 | $62.57 | |
BCBS
| Professional | $25.77 | $25.77 | $25.77 | |
Cigna
| Facility | $25.77 | $25.77 | $25.77 | |
Cigna
| Professional | $25.77 | $25.77 | $25.77 | |
United
| Professional | $25.77 | $25.77 | $28.69 |