| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $100.00 | $173.78 | $173.78 | |
Aetna
| Professional | $100.00 | $100.00 | $100.00 | |
Anthem BCBS
| Facility | $208.93 | $208.93 | $208.93 | |
Anthem BCBS
| Professional | $42.66 | $95.50 | $95.50 | |
Cigna
| Professional | $112.20 | $112.20 | $112.20 |