| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $416.78 | $416.78 | $437.62 | |
Aetna
| Professional | $416.78 | $416.78 | $416.78 | |
BCBS
| Facility | $479.30 | $479.30 | $479.30 | |
BCBS
| Professional | $479.30 | $479.30 | $479.30 | |
Cigna
| Facility | $416.78 | $416.78 | $416.78 | |
Molina
| Professional | $40.00 | $40.00 | $40.00 | |
United
| Professional | $175.07 | $250.07 | $708.53 |