| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $129.60 | $129.60 | $246.12 | |
Aetna
| Professional | $129.60 | $154.18 | $246.12 | |
BCBS
| Facility | $87.42 | $87.42 | $87.42 | |
BCBS
| Professional | $175.00 | $175.00 | $175.00 | |
Cigna
| Facility | $47.33 | $47.33 | $98.95 | |
Cigna
| Professional | $123.86 | $199.84 | $267.45 | |
Molina
| Professional | $32.34 | $32.34 | $32.34 | |
United
| Professional | $127.67 | $162.96 | $233.96 |