| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $147.91 | $147.91 | $275.42 | |
Aetna
| Professional | $104.71 | $131.83 | $186.21 | |
BCBS
| Facility | $109.65 | $109.65 | $109.65 | |
BCBS
| Professional | $104.71 | $109.65 | $109.65 | |
Cigna
| Professional | $190.55 | $190.55 | $239.88 | |
Health Alliance Plan
| Facility | $147.91 | $147.91 | $371.54 | |
Health Alliance Plan
| Professional | $128.82 | $158.49 | $213.80 | |
Priority Health
| Professional | $190.55 | $190.55 | $190.55 | |
United
| Facility | $141.25 | $158.49 | $186.21 | |
United
| Professional | $66.07 | $93.33 | $158.49 |