| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $75.00 | $75.00 | $75.00 | |
BCBS
| Facility | $24.15 | $24.15 | $26.57 | |
BCBS
| Professional | $23.00 | $23.00 | $23.00 | |
Cigna
| Professional | $23.00 | $50.00 | $105.33 | |
Molina
| Professional | $17.00 | $20.00 | $40.00 |