| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $190.00 | $190.00 | $296.39 | |
Aetna
| Professional | $170.00 | $190.00 | $190.00 | |
BCBS
| Facility | $133.24 | $133.24 | $140.25 | |
BCBS
| Professional | $133.24 | $140.25 | $156.00 | |
Cigna
| Professional | $243.67 | $243.67 | $304.58 | |
Health Alliance Plan
| Facility | $190.00 | $190.00 | $349.13 | |
Health Alliance Plan
| Professional | $190.00 | $192.00 | $240.00 | |
United
| Professional | $84.00 | $120.00 | $200.00 |