| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $106.80 | $106.80 | $122.06 | |
Aetna
| Professional | $101.72 | $106.80 | $122.06 | |
BCBS
| Professional | $171.00 | $171.00 | $171.00 | |
Cigna
| Facility | $101.72 | $101.72 | $101.72 | |
Cigna
| Professional | $101.72 | $101.72 | $101.72 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 | |
United
| Professional | $96.63 | $101.72 | $132.24 |