| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17.30 | $20.00 | $407.65 | |
Aetna
| Professional | $17.30 | $20.00 | $415.56 | |
Anthem BCBS
| Professional | $28.29 | $100.85 | $148.41 | |
CareSource
| Facility | $16.80 | $20.67 | $23.30 | |
CareSource
| Professional | $16.64 | $26.62 | $543.51 | |
Cigna
| Facility | $29.12 | $29.12 | $29.12 | |
Cigna
| Professional | $8.38 | $54.75 | $545.33 | |
Molina
| Professional | $32.34 | $32.34 | $454.95 | |
United
| Professional | $64.56 | $110.14 | $296.87 |