| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $180.95 | $180.95 | $264.80 | |
Aetna
| Professional | $176.54 | $187.57 | $264.80 | |
BCBS
| Facility | $156.00 | $156.00 | $156.00 | |
BCBS
| Professional | $156.84 | $156.84 | $156.84 | |
Cigna
| Facility | $135.85 | $179.96 | $235.38 | |
Cigna
| Professional | $187.57 | $187.57 | $187.57 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |