| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $87.57 | $87.57 | $87.57 | |
Aetna
| Professional | $87.57 | $87.57 | $400.00 | |
BCBS
| Facility | $44.10 | $44.10 | $48.51 | |
BCBS
| Professional | $42.00 | $42.00 | $42.00 | |
Cigna
| Professional | $255.00 | $255.00 | $293.25 | |
Molina
| Professional | $17.00 | $25.00 | $50.00 | |
United
| Professional | $173.00 | $240.45 | $240.45 |