| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $64.00 | $64.00 | $64.00 | |
Aetna
| Professional | $64.00 | $64.00 | $159.81 | |
BCBS
| Facility | $233.68 | $233.68 | $233.68 | |
BCBS
| Professional | $6.17 | $6.68 | $6.68 | |
Cigna
| Facility | $97.75 | $100.16 | $107.40 |