| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $104.71 | $104.71 | $104.71 | |
BCBS
| Professional | $66.07 | $83.18 | $102.33 | |
Cigna
| Facility | $131.83 | $131.83 | $131.83 | |
Cigna
| Professional | $117.49 | $117.49 | $147.91 | |
Medcost
| Facility | $104.71 | $104.71 | $125.89 | |
Molina
| Professional | $30.20 | $30.20 | $54.95 |