| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $23.17 | $23.17 | $23.17 | |
Aetna
| Professional | $23.17 | $23.17 | $23.17 | |
BCBS
| Facility | $157.00 | $157.00 | $157.00 | |
BCBS
| Professional | $22.00 | $22.00 | $22.00 | |
Cigna
| Facility | $99.00 | $99.00 | $102.00 | |
Cigna
| Professional | $16.39 | $16.39 | $88.13 |