| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $169.96 | $169.96 | $276.76 | |
Aetna
| Professional | $169.96 | $169.96 | $214.14 | |
Anthem BCBS
| Facility | $192.55 | $200.58 | $200.58 | |
Anthem BCBS
| Professional | $144.57 | $170.09 | $170.09 | |
CareSource
| Facility | $222.69 | $229.94 | $400.84 | |
CareSource
| Professional | $222.69 | $233.82 | $311.77 | |
Cigna
| Facility | $169.96 | $186.76 | $186.76 | |
Cigna
| Professional | $143.83 | $186.76 | $239.61 | |
United
| Professional | $166.75 | $191.76 | $199.95 |