| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.26 | $1.26 | $1.26 | |
Aetna
| Professional | $1.26 | $1.26 | $1.26 | |
BCBS
| Facility | $168.00 | $168.00 | $324.24 | |
BCBS
| Professional | $159.60 | $168.00 | $168.00 | |
Cigna
| Facility | $171.21 | $171.21 | $269.14 | |
Cigna
| Professional | $196.48 | $196.48 | $196.48 |