| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $125.50 | $125.50 | $125.50 | |
Aetna
| Professional | $125.50 | $125.50 | $158.12 | |
Anthem BCBS
| Facility | $133.63 | $145.25 | $145.25 | |
Anthem BCBS
| Professional | $114.75 | $135.00 | $135.00 | |
CareSource
| Facility | $72.91 | $75.28 | $131.24 | |
CareSource
| Professional | $61.97 | $76.56 | $102.07 | |
Cigna
| Facility | $80.34 | $95.82 | $137.94 | |
Cigna
| Professional | $106.49 | $137.94 | $400.69 | |
United
| Professional | $139.58 | $147.65 | $174.23 |