| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $229.63 | $229.63 | $229.63 | |
Aetna
| Professional | $229.63 | $229.63 | $229.63 | |
BCBS
| Facility | $929.08 | $1,797.05 | $3,080.20 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $549.90 | $549.90 | $549.90 | |
Medcost
| Facility | $229.63 | $241.11 | $486.82 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |