| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $183.59 | $183.59 | $286.39 | |
Aetna
| Professional | $166.20 | $183.59 | $183.59 | |
BCBS
| Facility | $135.52 | $135.52 | $135.52 | |
BCBS
| Professional | $128.74 | $135.52 | $150.74 | |
Cigna
| Professional | $91.47 | $108.29 | $268.67 | |
Health Alliance Plan
| Facility | $183.59 | $183.59 | $337.35 | |
Health Alliance Plan
| Professional | $183.59 | $185.52 | $231.90 | |
Molina
| Professional | $160.02 | $176.02 | $288.03 | |
United
| Professional | $81.17 | $115.95 | $193.25 |