| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $132.88 | $170.93 | $170.93 | |
Aetna
| Professional | $132.88 | $132.88 | $231.75 | |
BCBS
| Professional | $122.76 | $122.76 | $122.76 | |
Cigna
| Facility | $39.63 | $65.98 | $92.29 | |
Cigna
| Professional | $39.70 | $39.70 | $39.70 | |
Medcost
| Facility | $132.88 | $132.88 | $231.75 |