| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $174.58 | $174.58 | $399.00 | |
Aetna
| Professional | $131.09 | $151.62 | $174.58 | |
BCBS
| Facility | $253.97 | $253.97 | $253.97 | |
BCBS
| Professional | $228.57 | $253.97 | $317.45 | |
Cigna
| Professional | $185.59 | $188.67 | $307.62 | |
Health Alliance Plan
| Facility | $170.29 | $170.29 | $174.58 | |
Health Alliance Plan
| Professional | $137.15 | $170.29 | $235.52 | |
Molina
| Professional | $163.81 | $202.42 | $284.02 | |
United
| Professional | $163.88 | $189.76 | $247.28 |