| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $68.13 | $68.13 | $68.13 | |
Aetna
| Professional | $68.13 | $68.13 | $88.72 | |
BCBS
| Facility | $84.00 | $84.00 | $92.40 | |
BCBS
| Professional | $82.00 | $82.00 | $82.00 | |
Cigna
| Professional | $35.29 | $35.29 | $35.29 | |
Molina
| Professional | $17.00 | $21.25 | $50.00 |