| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $89.13 | $89.13 | $89.13 | |
Aetna
| Professional | $89.13 | $89.13 | $89.13 | |
BCBS
| Professional | $128.82 | $141.25 | $181.97 | |
Cigna
| Professional | $91.20 | $91.20 | $91.20 | |
Medcost
| Facility | $89.13 | $95.50 | $151.36 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 |