| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $85.40 | $251.03 | $616.58 | |
BCBS
| Facility | $54.64 | $116.94 | $220.61 | |
Cigna
| Facility | $175.54 | $175.54 | $175.54 | |
Cigna
| Professional | $114.44 | $114.44 | $114.44 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |