| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $468.33 | $857.04 | $1,157.00 | |
Aetna
| Professional | $351.25 | $351.25 | $351.25 | |
BCBS
| Facility | $608.83 | $632.25 | $632.25 | |
BCBS
| Professional | $2,525.00 | $2,525.00 | $2,525.00 | |
Cigna
| Facility | $304.41 | $304.41 | $319.63 | |
Molina
| Professional | $17.00 | $20.00 | $42.50 | |
United
| Professional | $196.70 | $281.00 | $702.50 |