| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $104.69 | $104.69 | $104.69 | |
Aetna
| Professional | $102.23 | $104.69 | $104.69 | |
BCBS
| Facility | $76.79 | $76.79 | $84.46 | |
Cigna
| Professional | $62.16 | $62.16 | $62.16 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |