| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $122.60 | $122.60 | $265.00 | |
Aetna
| Professional | $90.76 | $107.39 | $122.60 | |
BCBS
| Facility | $179.28 | $179.28 | $179.28 | |
BCBS
| Professional | $161.35 | $179.28 | $224.10 | |
Cigna
| Professional | $131.81 | $141.06 | $221.46 | |
Health Alliance Plan
| Facility | $111.54 | $111.54 | $122.60 | |
Health Alliance Plan
| Professional | $95.54 | $118.09 | $174.98 | |
Molina
| Professional | $109.20 | $134.94 | $189.34 | |
United
| Professional | $99.74 | $125.05 | $175.40 |