| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $116.11 | $116.11 | $181.13 | |
Aetna
| Professional | $105.11 | $116.11 | $128.44 | |
BCBS
| Facility | $99.15 | $139.47 | $242.82 | |
BCBS
| Professional | $87.09 | $91.67 | $98.09 | |
Cigna
| Professional | $62.08 | $90.21 | $170.11 | |
Health Alliance Plan
| Facility | $116.11 | $116.11 | $213.35 | |
Health Alliance Plan
| Professional | $116.11 | $141.96 | $164.67 | |
Molina
| Professional | $101.20 | $111.32 | $182.16 | |
United
| Professional | $51.33 | $73.33 | $150.88 |