| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Professional | $21.99 | $21.99 | $21.99 | |
Cigna
| Facility | $130.68 | $130.68 | $237.07 | |
Cigna
| Professional | $130.68 | $237.07 | $237.07 | |
Providence
| Facility | $130.68 | $187.14 | $237.07 | |
Providence
| Professional | $130.68 | $156.62 | $237.07 | |
United
| Professional | $95.39 | $96.63 | $111.43 |