| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $173.78 | $173.78 | $173.78 | |
Aetna
| Professional | $173.78 | $208.93 | $281.84 | |
BCBS
| Professional | $316.23 | $316.23 | $316.23 | |
Cigna
| Professional | $208.93 | $263.03 | $446.68 | |
Molina
| Professional | $32.36 | $32.36 | $33.11 | |
United
| Professional | $194.98 | $245.47 | $323.59 |