| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $252.64 | $252.64 | $252.64 | |
Aetna
| Professional | $252.64 | $252.64 | $252.64 | |
BCBS
| Facility | $31.94 | $34.54 | $61.64 | |
BCBS
| Professional | $31.94 | $31.94 | $35.45 | |
Cigna
| Professional | $105.40 | $105.40 | $105.40 |