| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $50.31 | $98.16 | $108.96 | |
Aetna
| Professional | $75.00 | $98.16 | $108.96 | |
BCBS
| Facility | $157.50 | $157.50 | $173.25 | |
Cigna
| Facility | $96.58 | $96.58 | $96.58 | |
Cigna
| Professional | $96.58 | $96.58 | $96.58 | |
Molina
| Professional | $20.00 | $20.00 | $20.00 | |
United
| Professional | $86.23 | $97.44 | $103.33 |