| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $30.20 | $30.20 | $30.20 | |
Ambetter
| Professional | $100.00 | $100.00 | $100.00 | |
BCBS
| Professional | $229.09 | $229.09 | $229.09 | |
Cigna
| Professional | $128.82 | $128.82 | $128.82 |