| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $206.72 | $206.72 | $206.72 | |
Aetna
| Professional | $206.72 | $206.72 | $206.72 | |
BCBS
| Facility | $118.08 | $118.08 | $227.89 | |
BCBS
| Professional | $51.81 | $57.57 | $162.94 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $155.87 | $155.87 | $155.87 |