| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $59.28 | $59.28 | $59.28 | |
BCBS
| Professional | $375.00 | $393.58 | $659.36 | |
Cigna
| Facility | $526.69 | $526.69 | $789.11 | |
Cigna
| Professional | $447.69 | $526.69 | $526.69 | |
Medcost
| Facility | $59.28 | $59.28 | $71.14 | |
Medcost
| Professional | $74.09 | $74.09 | $74.09 | |
Molina
| Professional | $30.00 | $30.00 | $70.00 |