| 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 | $140.69 | $140.69 | $154.77 | |
BCBS
| Professional | $134.00 | $134.00 | $134.00 | |
Cigna
| Professional | $196.48 | $196.48 | $196.48 | |
Molina
| Professional | $17.00 | $25.00 | $50.00 |