| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $95.27 | $95.27 | $95.27 | |
Aetna
| Professional | $68.19 | $82.07 | $95.27 | |
BCBS
| Facility | $132.96 | $132.96 | $132.96 | |
BCBS
| Professional | $126.31 | $139.61 | $166.20 | |
Cigna
| Professional | $79.45 | $79.45 | $119.06 | |
Health Alliance Plan
| Facility | $92.17 | $93.26 | $95.27 | |
Health Alliance Plan
| Professional | $82.07 | $93.26 | $120.03 | |
Molina
| Professional | $55.37 | $68.73 | $99.27 | |
United
| Professional | $90.56 | $106.42 | $136.55 |