| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $450.00 | $450.00 | $450.00 | |
Aetna
| Professional | $450.00 | $450.00 | $450.00 | |
BCBS
| Facility | $48.73 | $58.02 | $80.37 | |
BCBS
| Professional | $50.00 | $50.00 | $50.00 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $258.52 | $258.52 | $258.52 |