| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $85.93 | $106.74 | $135.59 | |
Aetna
| Professional | $85.93 | $110.06 | $156.03 | |
Anthem BCBS
| Professional | $71.75 | $90.87 | $123.77 | |
CareSource
| Facility | $121.65 | $156.85 | $196.40 | |
CareSource
| Professional | $122.75 | $147.30 | $202.54 | |
Cigna
| Facility | $151.61 | $151.61 | $151.61 | |
Cigna
| Professional | $108.64 | $215.75 | $618.98 | |
United
| Professional | $101.52 | $114.36 | $173.68 |