| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $416.87 | $416.87 | $891.25 | |
Aetna
| Professional | $416.87 | $416.87 | $416.87 | |
BCBS
| Facility | $478.63 | $478.63 | $478.63 | |
BCBS
| Professional | $478.63 | $478.63 | $478.63 | |
Cigna
| Facility | $416.87 | $416.87 | $416.87 | |
Molina
| Professional | $39.81 | $39.81 | $39.81 | |
United
| Facility | $371.54 | $371.54 | $501.19 | |
United
| Professional | $173.78 | $251.19 | $933.25 |