| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.00 | $19.00 | $19.00 | |
Aetna
| Professional | $16.50 | $19.00 | $26.58 | |
Ambetter
| Professional | $22.64 | $22.64 | $22.64 | |
Anthem BCBS
| Professional | $15.24 | $19.57 | $25.22 | |
CareSource
| Facility | $17.02 | $17.02 | $30.07 | |
CareSource
| Professional | $17.02 | $31.57 | $37.59 | |
Cigna
| Professional | $19.57 | $25.24 | $44.48 | |
United
| Professional | $28.43 | $35.90 | $57.13 |