| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $89.88 | $89.88 | $89.88 | |
Aetna
| Professional | $89.88 | $174.10 | $253.70 | |
BCBS
| Facility | $258.67 | $258.67 | $258.67 | |
Cigna
| Facility | $440.01 | $440.01 | $440.01 | |
Cigna
| Professional | $161.72 | $161.72 | $161.72 |