| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $371.21 | $371.21 | $579.09 | |
Aetna
| Professional | $320.42 | $371.21 | $371.21 | |
BCBS
| Facility | $260.31 | $260.31 | $274.01 | |
BCBS
| Professional | $260.31 | $274.01 | $369.91 | |
Cigna
| Professional | $448.93 | $476.19 | $595.24 | |
Health Alliance Plan
| Facility | $371.21 | $371.21 | $682.10 | |
Health Alliance Plan
| Professional | $371.21 | $375.12 | $468.90 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 | |
United
| Professional | $164.12 | $234.45 | $248.52 |