| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $104.40 | $104.40 | $104.40 | |
BCBS
| Professional | $66.50 | $83.00 | $104.65 | |
Cigna
| Facility | $132.44 | $132.44 | $132.44 | |
Medcost
| Facility | $104.40 | $104.40 | $125.28 | |
Molina
| Professional | $30.00 | $30.00 | $55.00 |