| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $58.76 | $58.76 | $58.76 | |
BCBS
| Facility | $196.49 | $444.68 | $708.26 | |
Cigna
| Facility | $583.49 | $583.49 | $583.49 | |
Medcost
| Professional | $450.40 | $450.40 | $450.40 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |