| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $690.17 | $690.18 | $1,813.20 | |
Aetna
| Professional | $690.18 | $690.18 | $923.10 | |
BCBS
| Facility | $681.00 | $681.00 | $681.00 | |
BCBS
| Professional | $681.00 | $681.00 | $681.00 | |
Cigna
| Professional | $240.52 | $240.52 | $240.52 | |
Molina
| Professional | $17.00 | $21.25 | $50.00 |