| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $22.91 | $22.91 | $22.91 | |
Aetna
| Professional | $5.01 | $22.91 | $22.91 | |
Ambetter
| Professional | $30.20 | $30.20 | $30.20 | |
BCBS
| Facility | $44.67 | $52.48 | $70.79 | |
Cigna
| Facility | $93.33 | $93.33 | $128.82 | |
Cigna
| Professional | $50.12 | $50.12 | $70.79 |