| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.00 | $40.00 | $40.00 | |
Aetna
| Professional | $40.00 | $40.00 | $40.00 | |
BCBS
| Facility | $218.00 | $218.00 | $420.74 | |
BCBS
| Professional | $207.10 | $218.00 | $218.00 | |
Cigna
| Facility | $191.40 | $191.40 | $191.40 | |
Cigna
| Professional | $139.72 | $139.72 | $139.72 |