| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.84 | $40.74 | $40.74 | |
Aetna
| Professional | $34.67 | $52.48 | $58.88 | |
Anthem BCBS
| Professional | $61.66 | $79.43 | $91.20 | |
CareSource
| Facility | $67.61 | $1,023.29 | $46,773.51 | |
CareSource
| Professional | $57.54 | $891.25 | $1,584.89 | |
Cigna
| Facility | $87.10 | $87.10 | $87.10 | |
Cigna
| Professional | $263.03 | $263.03 | $263.03 | |
Molina
| Professional | $44.67 | $44.67 | $44.67 | |
United
| Professional | $48.98 | $61.66 | $107.15 |