| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $249.20 | $249.20 | $249.20 | |
Aetna
| Professional | $249.20 | $265.72 | $287.64 | |
Ambetter
| Professional | $248.87 | $248.87 | $248.87 | |
BCBS
| Professional | $150.00 | $150.00 | $150.00 | |
Cigna
| Professional | $22.70 | $22.70 | $22.70 | |
Molina
| Professional | $246.58 | $250.57 | $1,000.00 | |
United
| Professional | $258.47 | $258.47 | $258.47 |