| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $87.10 | $102.99 | $132.93 | |
Aetna
| Professional | $67.55 | $84.89 | $102.99 | |
BCBS
| Facility | $125.99 | $125.99 | $125.99 | |
BCBS
| Professional | $113.39 | $125.99 | $157.49 | |
Cigna
| Professional | $86.45 | $117.70 | $197.63 | |
Health Alliance Plan
| Facility | $87.10 | $101.58 | $113.23 | |
Health Alliance Plan
| Professional | $72.09 | $101.58 | $119.10 | |
Molina
| Professional | $30.00 | $83.50 | $98.23 | |
United
| Professional | $92.66 | $114.31 | $150.97 |