| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $70.00 | $70.00 | $70.00 | |
Aetna
| Professional | $70.00 | $70.00 | $70.00 | |
BCBS
| Facility | $130.19 | $130.19 | $143.22 | |
BCBS
| Professional | $124.00 | $124.00 | $124.00 | |
Cigna
| Professional | $51.00 | $51.00 | $51.00 | |
Molina
| Professional | $17.00 | $25.00 | $50.00 |