| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.32 | $20.32 | $24.68 | |
Aetna
| Professional | $20.32 | $20.32 | $20.32 | |
BCBS
| Facility | $104.00 | $104.00 | $200.72 | |
BCBS
| Professional | $50.40 | $56.00 | $143.52 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $76.11 | $76.11 | $76.11 |