| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $49.79 | $49.79 | $79.36 | |
Aetna
| Professional | $49.79 | $58.44 | $84.51 | |
BCBS
| Facility | $175.35 | $175.35 | $192.89 | |
BCBS
| Professional | $167.00 | $167.00 | $167.00 | |
Cigna
| Facility | $75.05 | $75.05 | $75.05 | |
Cigna
| Professional | $54.79 | $54.79 | $75.05 | |
Molina
| Professional | $17.00 | $21.25 | $50.00 | |
United
| Professional | $38.54 | $50.90 | $86.73 |