| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $26.83 | $26.83 | $26.83 | |
Aetna
| Professional | $23.43 | $26.83 | $37.40 | |
Anthem BCBS
| Facility | $86.74 | $86.74 | $167.41 | |
Anthem BCBS
| Professional | $59.19 | $86.74 | $123.17 | |
CareSource
| Facility | $40.25 | $619.74 | $43,749.56 | |
Cigna
| Professional | $32.11 | $37.78 | $37.78 | |
United
| Professional | $37.93 | $50.36 | $78.48 |