| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $412.43 | $412.43 | $412.43 | |
Aetna
| Professional | $412.43 | $412.43 | $412.43 | |
BCBS
| Facility | $268.17 | $517.14 | $867.07 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $73.18 | $73.18 | $73.18 | |
Medcost
| Facility | $412.43 | $424.13 | $701.13 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |