| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $72.44 | $72.44 | $72.44 | |
Aetna
| Professional | $72.44 | $72.44 | $74.13 | |
Anthem BCBS
| Facility | $85.11 | $114.82 | $173.78 | |
Anthem BCBS
| Professional | $66.07 | $66.07 | $66.07 | |
Cigna
| Facility | $72.44 | $72.44 | $72.44 | |
Cigna
| Professional | $72.44 | $72.44 | $72.44 | |
United
| Professional | $69.18 | $74.13 | $81.28 |