| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $186.23 | $188.06 | $188.06 | |
BCBS
| Facility | $155.03 | $275.39 | $607.76 | |
Cigna
| Facility | $212.02 | $212.02 | $212.02 | |
Health Alliance Plan
| Facility | $197.71 | $197.71 | $197.71 |