| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $147.91 | $147.91 | $154.88 | |
Ambetter
| Facility | $147.91 | $147.91 | $147.91 | |
BCBS
| Facility | $41.69 | $204.17 | $1,023.29 | |
Cigna
| Facility | $67.61 | $67.61 | $67.61 |
Clinic-Other Clinic
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $147.91 | $147.91 | $154.88 | |
Ambetter
| Facility | $147.91 | $147.91 | $147.91 | |
BCBS
| Facility | $41.69 | $204.17 | $1,023.29 | |
Cigna
| Facility | $67.61 | $67.61 | $67.61 |