| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $166.07 | $166.07 | $259.07 | |
Aetna
| Professional | $149.46 | $166.07 | $166.07 | |
BCBS
| Facility | $116.46 | $116.46 | $122.59 | |
BCBS
| Professional | $116.46 | $122.59 | $136.35 | |
Cigna
| Professional | $213.11 | $266.39 | $393.32 | |
Health Alliance Plan
| Facility | $166.07 | $166.07 | $305.14 | |
Health Alliance Plan
| Professional | $166.07 | $167.82 | $209.77 | |
United
| Facility | $174.81 | $174.81 | $209.77 | |
United
| Professional | $73.42 | $104.89 | $174.81 |