| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Cigna
| Professional | $125.89 | $125.89 | $158.49 | |
Horizon BCBS
| Facility | $114.82 | $10,471.29 | $25,703.96 | |
Horizon BCBS
| Professional | $74.13 | $91.20 | $91.20 | |
United
| Facility | $39.81 | $51.29 | $114.82 | |
United
| Professional | $51.29 | $51.29 | $51.29 |