| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $55.50 | $104.67 | $116.18 | |
Aetna
| Professional | $99.00 | $104.67 | $121.50 | |
BCBS
| Facility | $86.25 | $86.25 | $86.25 | |
Cigna
| Facility | $92.64 | $115.07 | $115.07 | |
Cigna
| Professional | $115.07 | $115.07 | $115.07 | |
Molina
| Professional | $20.00 | $20.00 | $20.00 | |
United
| Professional | $102.74 | $105.82 | $123.14 |