| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.27 | $19.27 | $19.27 | |
Aetna
| Professional | $19.27 | $19.27 | $19.27 | |
BCBS
| Facility | $17.18 | $18.53 | $23.77 | |
BCBS
| Professional | $19.16 | $20.00 | $23.73 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $68.79 | $68.79 | $176.25 |