| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $55.54 | $55.54 | $55.54 | |
Aetna
| Professional | $55.54 | $55.54 | $55.54 | |
Anthem BCBS
| Facility | $597.00 | $597.00 | $796.00 | |
Anthem BCBS
| Professional | $0.02 | $0.02 | $0.02 | |
Cigna
| Facility | $46.30 | $99.49 | $163.41 |