| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $144.54 | $144.54 | $144.54 | |
Aetna
| Professional | $144.54 | $194.98 | $239.88 | |
BCBS
| Facility | $208.93 | $208.93 | $208.93 | |
BCBS
| Professional | $208.93 | $208.93 | $208.93 | |
Cigna
| Professional | $181.97 | $181.97 | $181.97 | |
Molina
| Professional | $32.36 | $32.36 | $33.11 | |
United
| Professional | $169.82 | $213.80 | $323.59 |