| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $50.00 | $50.00 | $50.00 | |
BCBS
| Facility | $14.14 | $30.16 | $57.32 | |
BCBS
| Professional | $9.50 | $10.40 | $13.50 | |
Cigna
| Professional | $14.40 | $14.40 | $14.40 | |
Health Alliance Plan
| Professional | $50.00 | $50.00 | $50.00 | |
Molina
| Professional | $21.60 | $21.60 | $55.00 |