| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $117.99 | $117.99 | $117.99 | |
Aetna
| Professional | $12.50 | $97.93 | $137.74 | |
Anthem BCBS
| Professional | $30.48 | $54.03 | $72.52 | |
CareSource
| Facility | $20.21 | $20.21 | $1,630.83 | |
CareSource
| Professional | $20.21 | $111.92 | $138.57 | |
Cigna
| Professional | $19.00 | $25.00 | $64.12 | |
United
| Professional | $23.82 | $122.14 | $203.75 |