| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $15.40 | $15.40 | $15.40 | |
Aetna
| Professional | $15.40 | $15.40 | $15.40 | |
BCBS
| Facility | $157.00 | $157.00 | $157.00 | |
BCBS
| Professional | $20.00 | $21.06 | $39.50 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $26.40 | $26.40 | $26.40 |