| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $14.82 | $14.82 | $14.82 | |
Aetna
| Professional | $14.82 | $14.82 | $72.65 | |
BCBS
| Facility | $168.65 | $168.65 | $168.65 | |
BCBS
| Professional | $6.17 | $6.68 | $6.68 | |
Cigna
| Facility | $76.66 | $78.40 | $85.37 | |
Cigna
| Professional | $130.77 | $130.77 | $130.77 |