| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $15.44 | $15.44 | $15.44 | |
Aetna
| Professional | $12.75 | $15.24 | $18.70 | |
Anthem BCBS
| Professional | $15.22 | $21.47 | $28.92 | |
CareSource
| Facility | $20.07 | $22.18 | $28.22 | |
CareSource
| Professional | $20.16 | $23.09 | $28.31 | |
Cigna
| Facility | $65.00 | $65.00 | $110.00 | |
Cigna
| Professional | $18.23 | $24.44 | $36.50 | |
United
| Professional | $18.78 | $22.54 | $27.95 |