| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.90 | $30.90 | $33.88 | |
Aetna
| Professional | $30.20 | $30.20 | $33.88 | |
Anthem BCBS
| Facility | $40.74 | $79.43 | $131.83 | |
Anthem BCBS
| Professional | $30.90 | $30.90 | $34.67 | |
Cigna
| Facility | $33.88 | $33.88 | $33.88 | |
Cigna
| Professional | $33.88 | $33.88 | $33.88 | |
Harvard Pilgrim
| Professional | $33.88 | $57.54 | $64.57 | |
United
| Professional | $30.20 | $33.88 | $38.90 |