| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $540.96 | $540.96 | $540.96 | |
Aetna
| Professional | $540.96 | $540.96 | $677.60 | |
BCBS
| Facility | $804.54 | $1,745.05 | $2,705.03 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $920.40 | $920.40 | $920.40 | |
Medcost
| Facility | $542.08 | $569.17 | $1,011.16 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |