| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $8.00 | $8.00 | $8.00 | |
Anthem BCBS
| Facility | $729.62 | $729.62 | $1,408.17 | |
Anthem BCBS
| Professional | $2.02 | $729.62 | $1,006.87 | |
CareSource
| Facility | $13.16 | $13.16 | $13.16 | |
Cigna
| Professional | $21.00 | $21.00 | $963.10 |