| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $21.20 | $21.20 | $21.20 | |
Aetna
| Professional | $18.48 | $21.20 | $66.83 | |
Anthem BCBS
| Facility | $158.61 | $158.61 | $306.12 | |
Anthem BCBS
| Professional | $83.72 | $154.03 | $213.67 | |
CareSource
| Facility | $15.41 | $231.22 | $380.97 | |
Cigna
| Professional | $209.37 | $209.37 | $209.37 | |
United
| Professional | $57.11 | $97.08 | $168.97 |