| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $20.43 | $20.43 | $20.43 | |
Aetna
| Professional | $19.70 | $20.43 | $20.43 | |
BCBS
| Facility | $702.39 | $852.39 | $1,146.73 | |
Cigna
| Facility | $20.43 | $20.43 | $20.43 | |
Cigna
| Professional | $20.43 | $20.43 | $24.14 |