| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $169.96 | $169.96 | $277.94 | |
Aetna
| Professional | $169.96 | $169.96 | $186.95 | |
BCBS
| Facility | $189.95 | $189.95 | $284.92 | |
BCBS
| Professional | $189.95 | $189.95 | $193.75 | |
Christus
| Facility | $115.60 | $115.60 | $115.60 | |
Cigna
| Facility | $186.76 | $186.76 | $186.76 | |
Cigna
| Professional | $186.76 | $186.76 | $186.76 | |
United
| Professional | $159.96 | $188.43 | $200.10 |