| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $472.07 | $472.07 | $472.07 | |
Aetna
| Professional | $299.74 | $300.00 | $627.20 | |
Anthem BCBS
| Professional | $70.18 | $95.88 | $132.80 | |
Cigna
| Professional | $49.95 | $49.95 | $49.95 |