| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $528.75 | $528.75 | $2,851.50 | |
Aetna
| Professional | $398.00 | $398.00 | $2,851.50 | |
Anthem BCBS
| Facility | $514.00 | $1,051.00 | $2,785.15 | |
Anthem BCBS
| Professional | $285.86 | $310.23 | $440.52 | |
CareSource
| Facility | $43,749.56 | $52,499.48 | $89,999.10 | |
Cigna
| Facility | $683.82 | $683.82 | $950.50 | |
Cigna
| Professional | $0.66 | $0.66 | $0.66 |