| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $79.43 | $97.72 | $97.72 | |
Aetna
| Professional | $79.43 | $97.72 | $97.72 | |
BCBS
| Facility | $28.18 | $35.48 | $89.13 | |
BCBS
| Professional | $38.02 | $38.02 | $93.33 | |
Cigna
| Facility | $95.50 | $95.50 | $95.50 | |
Cigna
| Professional | $69.18 | $69.18 | $95.50 |