| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $50.00 | $50.00 | $50.00 | |
Anthem BCBS
| Facility | $43.92 | $43.92 | $84.77 | |
Anthem BCBS
| Professional | $1.23 | $43.92 | $60.60 | |
CareSource
| Facility | $13.16 | $13.16 | $13.16 | |
Cigna
| Professional | $57.97 | $57.97 | $57.97 |