| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.02 | $0.02 | $125.50 | |
Aetna
| Professional | $125.50 | $125.50 | $125.50 | |
Anthem BCBS
| Facility | $0.02 | $0.02 | $135.00 | |
Anthem BCBS
| Professional | $114.75 | $135.00 | $191.68 | |
CareSource
| Facility | $76.65 | $84.32 | $84.32 | |
CareSource
| Professional | $84.32 | $84.32 | $84.32 | |
Cigna
| Facility | $137.94 | $137.94 | $137.94 | |
Cigna
| Professional | $137.94 | $137.94 | $379.36 | |
United
| Professional | $147.65 | $147.65 | $177.18 |