| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $112.02 | $205.00 | $227.40 | |
Aetna
| Professional | $88.50 | $88.50 | $88.50 | |
BCBS
| Facility | $76.47 | $76.47 | $76.47 | |
BCBS
| Professional | $76.47 | $76.47 | $76.47 | |
Cigna
| Facility | $72.81 | $72.81 | $76.45 | |
Cigna
| Professional | $128.44 | $128.44 | $160.55 | |
Molina
| Professional | $17.00 | $20.00 | $20.00 | |
United
| Professional | $47.05 | $56.01 | $191.21 |