| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $47.49 | $57.45 | $68.54 | |
BCBS
| Facility | $30.00 | $30.00 | $30.00 | |
BCBS
| Professional | $30.00 | $30.00 | $30.00 | |
Cigna
| Professional | $14.25 | $14.25 | $76.41 | |
Health Alliance Plan
| Professional | $18.60 | $57.45 | $68.54 | |
Molina
| Professional | $55.00 | $68.31 | $68.31 |