| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $125.50 | $125.50 | $707.70 | |
Aetna
| Professional | $125.50 | $125.50 | $130.57 | |
Anthem BCBS
| Facility | $0.03 | $0.03 | $0.03 | |
Anthem BCBS
| Professional | $135.00 | $147.65 | $147.65 | |
Cigna
| Facility | $137.94 | $137.94 | $137.94 | |
Cigna
| Professional | $137.94 | $137.94 | $137.94 | |
Hometown Health
| Professional | $125.50 | $125.50 | $190.00 | |
United
| Professional | $147.65 | $147.65 | $166.84 |