| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $132.88 | $132.88 | $132.88 | |
Aetna
| Professional | $132.88 | $132.88 | $132.88 | |
BCBS
| Facility | $108.41 | $191.97 | $323.92 | |
Cigna
| Facility | $44.21 | $149.68 | $235.24 | |
Medcost
| Facility | $132.88 | $164.77 | $278.10 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |