| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $87.10 | $102.99 | $102.99 | |
Aetna
| Professional | $68.25 | $87.10 | $105.43 | |
BCBS
| Facility | $125.99 | $125.99 | $125.99 | |
BCBS
| Professional | $119.69 | $132.29 | $157.49 | |
Cigna
| Facility | $113.46 | $113.46 | $113.46 | |
Cigna
| Professional | $79.36 | $113.83 | $279.06 | |
Health Alliance Plan
| Facility | $87.10 | $103.87 | $132.93 | |
Health Alliance Plan
| Professional | $77.89 | $103.87 | $133.72 | |
Molina
| Professional | $30.00 | $75.00 | $169.93 | |
United
| Professional | $94.40 | $117.51 | $160.25 |