| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $12.00 | $12.00 | $51.15 | |
BCBS
| Facility | $59.00 | $59.00 | $64.90 | |
BCBS
| Professional | $59.00 | $59.00 | $59.00 | |
Cigna
| Professional | $8.96 | $8.96 | $8.96 | |
Molina
| Professional | $17.00 | $20.00 | $25.00 |