| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $13.00 | $69.52 | $210.64 | |
Aetna
| Professional | $62.50 | $112.50 | $187.50 | |
BCBS
| Facility | $0.02 | $0.02 | $0.02 | |
BCBS
| Professional | $191.25 | $225.00 | $250.00 | |
Cigna
| Facility | $575.00 | $575.00 | $575.00 |