| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $50.12 | $50.12 | $50.12 | |
Aetna
| Professional | $50.12 | $50.12 | $50.12 | |
Anthem BCBS
| Facility | $43.65 | $43.65 | $85.11 | |
Anthem BCBS
| Professional | $1.23 | $43.65 | $67.61 | |
Cigna
| Professional | $57.54 | $57.54 | $57.54 |