| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17.10 | $17.10 | $17.10 | |
Aetna
| Professional | $17.10 | $17.10 | $17.10 | |
BCBS
| Facility | $52.58 | $89.75 | $132.61 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $203.99 | $203.99 | $203.99 |