| 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 | $123.75 | $123.75 | $279.49 | |
BCBS
| Professional | $105.19 | $123.75 | $201.61 | |
Cigna
| Professional | $139.72 | $139.72 | $139.72 |