| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $100.00 | $100.00 | $100.00 | |
BCBS
| Facility | $201.60 | $201.60 | $221.76 | |
BCBS
| Professional | $192.00 | $192.00 | $192.00 | |
Cigna
| Professional | $13.25 | $13.25 | $13.25 | |
Molina
| Professional | $20.00 | $20.00 | $25.00 |