| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $21.64 | $21.64 | $21.64 | |
BCBS
| Professional | $14.00 | $14.00 | $27.19 | |
Cigna
| Professional | $14.22 | $14.22 | $15.58 | |
Medcost
| Facility | $21.64 | $30.00 | $38.22 | |
Molina
| Professional | $14.88 | $14.88 | $14.88 | |
United
| Professional | $11.36 | $14.79 | $21.64 |