| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $93.20 | $187.48 | $376.10 | |
Aetna
| Professional | $55.74 | $69.37 | $310.00 | |
Aetna
| Professional | CQ | $57.12 | $57.12 | $57.12 |
Anthem BCBS
| Professional | $72.84 | $75.00 | $133.19 | |
Cigna
| Facility | $55.00 | $60.00 | $70.00 | |
Cigna
| Professional | $48.87 | $79.98 | $100.55 | |
Hometown Health
| Professional | $0.40 | $87.15 | $132.80 | |
Hometown Health
| Professional | $0.40 | $98.19 | $147.29 | |
United
| Professional | $74.55 | $87.70 | $133.93 |