| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $50.00 | $50.00 | $50.00 | |
Aetna
| Professional | $50.00 | $50.00 | $50.00 | |
Anthem BCBS
| Professional | $1.39 | $1.66 | $3.13 | |
CareSource
| Facility | $14.35 | $17.11 | $19.54 | |
CareSource
| Professional | $13.82 | $13.82 | $13.82 | |
Cigna
| Professional | $14.40 | $14.40 | $14.40 | |
Molina
| Professional | $10.72 | $17.45 | $22.99 |