| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $125.89 | $125.89 | $177.83 | |
Aetna
| Professional | $125.89 | $125.89 | $138.04 | |
Anthem BCBS
| Facility | $0.03 | $144.54 | $144.54 | |
Anthem BCBS
| Professional | $114.82 | $134.90 | $134.90 | |
CareSource
| Facility | $72.44 | $72.44 | $117.49 | |
CareSource
| Professional | $61.66 | $75.86 | $102.33 | |
Cigna
| Facility | $131.83 | $131.83 | $131.83 | |
Cigna
| Professional | $398.11 | $398.11 | $398.11 | |
United
| Professional | $147.91 | $147.91 | $173.78 |