| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $588.62 | $588.62 | $588.62 | |
Aetna
| Professional | $588.62 | $588.62 | $588.62 | |
BCBS
| Facility | $87.20 | $100.00 | $1,450.57 | |
BCBS
| Professional | $0.02 | $0.02 | $0.02 | |
Cigna
| Professional | $781.33 | $781.33 | $781.33 |