| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $177.88 | $177.88 | $177.88 | |
Aetna
| Professional | $160.24 | $178.48 | $214.06 | |
Ambetter
| Professional | $197.55 | $204.46 | $204.46 | |
BCBS
| Professional | $204.46 | $204.46 | $204.46 | |
Cigna
| Professional | $45.05 | $45.05 | $45.05 | |
Medcost
| Facility | $155.00 | $187.88 | $232.02 | |
Molina
| Professional | $3,000.00 | $3,000.00 | $3,000.00 |