| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $290.00 | $328.00 | $452.00 | |
BCBS
| Facility | $250.00 | $417.00 | $711.00 | |
Cigna
| Facility | $149.35 | $347.44 | $484.89 | |
Health Alliance Plan
| Facility | $290.00 | $422.28 | $685.00 |