| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $138.91 | $138.91 | $138.91 | |
Aetna
| Professional | $138.91 | $138.91 | $138.91 | |
BCBS
| Facility | $40.21 | $40.21 | $77.61 | |
BCBS
| Professional | $37.15 | $40.21 | $41.29 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $48.86 | $51.91 | $51.91 |