| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $67.15 | $67.15 | $67.15 | |
Aetna
| Professional | $67.15 | $67.15 | $73.33 | |
BCBS
| Facility | $54.15 | $60.00 | $60.00 | |
BCBS
| Professional | $35.40 | $35.40 | $44.48 | |
Cigna
| Facility | $30.72 | $30.72 | $30.72 | |
Cigna
| Professional | $26.11 | $30.72 | $108.87 |