| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $114.43 | $209.41 | $282.70 | |
Aetna
| Professional | $90.40 | $90.40 | $90.40 | |
BCBS
| Facility | $114.43 | $114.43 | $114.43 | |
BCBS
| Professional | $114.43 | $114.43 | $114.43 | |
Cigna
| Facility | $74.38 | $78.09 | $86.80 | |
Molina
| Professional | $40.00 | $40.00 | $40.00 | |
United
| Professional | $48.06 | $68.66 | $194.53 |