| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $65.53 | $65.53 | $74.90 | |
Aetna
| Professional | $62.41 | $65.53 | $74.90 | |
BCBS
| Facility | $54.22 | $54.22 | $54.22 | |
BCBS
| Professional | $87.75 | $87.75 | $87.75 | |
Cigna
| Facility | $62.41 | $62.41 | $62.41 | |
Cigna
| Professional | $62.41 | $62.41 | $62.41 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 | |
United
| Professional | $59.29 | $62.41 | $81.13 |