| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $234.57 | $234.57 | $365.93 | |
Aetna
| Professional | $202.47 | $234.57 | $234.57 | |
BCBS
| Facility | $164.49 | $164.49 | $173.15 | |
BCBS
| Professional | $164.49 | $173.15 | $233.75 | |
Cigna
| Professional | $246.92 | $301.08 | $376.35 | |
Health Alliance Plan
| Facility | $234.57 | $234.57 | $431.02 | |
Health Alliance Plan
| Professional | $234.57 | $237.04 | $296.30 | |
United
| Professional | $103.71 | $148.15 | $246.92 |