| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $130.15 | $130.15 | $203.03 | |
Aetna
| Professional | $117.82 | $130.15 | $130.15 | |
BCBS
| Facility | $111.79 | $156.32 | $272.17 | |
Cigna
| Professional | $62.74 | $81.81 | $208.56 | |
Health Alliance Plan
| Facility | $130.15 | $130.15 | $239.15 | |
Health Alliance Plan
| Professional | $130.15 | $131.52 | $164.40 | |
Molina
| Professional | $113.44 | $124.78 | $204.19 | |
United
| Professional | $57.54 | $82.20 | $178.10 |