| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $82.73 | $82.73 | $82.73 | |
Aetna
| Professional | $59.24 | $70.48 | $82.73 | |
BCBS
| Facility | $115.53 | $115.53 | $115.53 | |
BCBS
| Professional | $109.75 | $121.31 | $144.41 | |
Cigna
| Professional | $69.04 | $69.04 | $103.35 | |
Health Alliance Plan
| Facility | $78.89 | $78.89 | $82.73 | |
Health Alliance Plan
| Professional | $70.61 | $78.89 | $104.16 | |
Molina
| Professional | $55.37 | $68.73 | $99.27 | |
United
| Professional | $74.55 | $89.72 | $114.02 |