| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $87.10 | $87.10 | $102.99 | |
Aetna
| Professional | $65.48 | $87.10 | $105.43 | |
BCBS
| Professional | $119.69 | $125.99 | $170.09 | |
CareSource
| Facility | $58.55 | $58.55 | $58.55 | |
Cigna
| Professional | $129.05 | $139.90 | $213.82 | |
Health Alliance Plan
| Professional | $78.98 | $102.88 | $126.15 | |
Molina
| Professional | $30.00 | $30.00 | $86.45 | |
United
| Professional | $93.27 | $109.74 | $133.54 |