| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $25.00 | $25.00 | $25.00 | |
Aetna
| Professional | $25.00 | $25.00 | $25.00 | |
Anthem BCBS
| Facility | $23.80 | $23.80 | $45.93 | |
Anthem BCBS
| Professional | $23.80 | $23.80 | $32.06 | |
CareSource
| Facility | $21.17 | $54.00 | $62.40 | |
Cigna
| Facility | $32.74 | $32.74 | $32.74 | |
Cigna
| Professional | $23.90 | $30.74 | $32.74 |