| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $50.00 | $50.00 | $50.00 | |
Aetna
| Professional | $50.00 | $50.00 | $50.00 | |
BCBS
| Facility | $42.80 | $43.92 | $84.77 | |
BCBS
| Professional | $1.39 | $43.92 | $43.92 | |
Cigna
| Professional | $14.40 | $14.40 | $14.40 |