| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $574.78 | $574.78 | $739.96 | |
BCBS
| Facility | $826.15 | $826.15 | $826.15 | |
Cigna
| Facility | $635.70 | $635.70 | $635.70 | |
Health Alliance Plan
| Facility | $547.40 | $547.40 | $730.08 |