| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $212.34 | $212.34 | $212.34 | |
Aetna
| Professional | $212.34 | $212.34 | $212.34 | |
BCBS
| Facility | $26.28 | $28.42 | $50.72 | |
BCBS
| Professional | $26.28 | $26.28 | $29.17 | |
Cigna
| Professional | $86.72 | $86.72 | $86.72 |