| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $131.11 | $262.20 | $524.42 | |
Aetna
| Professional | $131.11 | $209.77 | $1,124.03 | |
BCBS
| Facility | $174.81 | $907.98 | $1,566.73 | |
BCBS
| Professional | $107.24 | $142.99 | $174.81 | |
Cigna
| Facility | $113.63 | $113.63 | $113.63 | |
Cigna
| Professional | $156.59 | $211.10 | $290.33 | |
Molina
| Professional | $60.00 | $60.00 | $284.94 | |
Providence
| Facility | $113.63 | $174.81 | $220.26 | |
Providence
| Professional | $179.83 | $211.52 | $251.73 | |
United
| Professional | $73.42 | $73.42 | $104.89 |