| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $88.76 | $88.76 | $88.76 | |
Aetna
| Professional | $88.76 | $88.76 | $88.76 | |
BCBS
| Facility | $72.56 | $94.06 | $222.53 | |
BCBS
| Professional | $61.67 | $72.56 | $72.56 | |
Cigna
| Professional | $95.78 | $95.78 | $95.78 |