| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $8.00 | $8.00 | $8.00 | |
BCBS
| Professional | $76.00 | $83.14 | $116.45 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $10.84 | $10.84 | $10.84 | |
Medcost
| Facility | $8.00 | $9.92 | $22.00 | |
Medcost
| Professional | $22.00 | $22.00 | $22.00 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |