| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $45.76 | $45.76 | $45.76 | |
Aetna
| Professional | $45.76 | $45.76 | $45.76 | |
BCBS
| Facility | $86.10 | $240.38 | $583.04 | |
Cigna
| Facility | $987.88 | $987.88 | $987.88 | |
Medcost
| Facility | $45.76 | $50.34 | $65.51 | |
Medcost
| Professional | $360.19 | $360.19 | $360.19 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |