| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $104.40 | $104.40 | $104.40 | |
Aetna
| Professional | $104.40 | $104.40 | $104.40 | |
BCBS
| Facility | $54.15 | $60.00 | $60.00 | |
BCBS
| Professional | $112.22 | $112.22 | $112.22 | |
Cigna
| Facility | $136.42 | $136.42 | $140.40 | |
Cigna
| Professional | $140.40 | $140.40 | $140.40 |