| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $10.65 | $230.18 | $361.54 | |
Aetna
| Facility | 25 | $95.03 | $120.80 | $681.36 |
Anthem BCBS
| Facility | $278.00 | $278.00 | $348.00 | |
CareSource
| Facility | $10.00 | $12.42 | $15.53 | |
Cigna
| Facility | $13.19 | $13.19 | $13.19 |