| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $157.00 | $157.00 | $157.00 | |
Aetna
| Professional | $157.00 | $157.00 | $157.00 | |
Anthem BCBS
| Professional | $10.73 | $10.73 | $12.62 | |
Cigna
| Professional | $24.99 | $24.99 | $24.99 |