| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $75.00 | $75.00 | $75.00 | |
Aetna
| Professional | $75.00 | $75.00 | $75.00 | |
Anthem BCBS
| Facility | $187.00 | $187.00 | $360.91 | |
Anthem BCBS
| Professional | $52.80 | $187.00 | $258.06 | |
Cigna
| Professional | $98.27 | $98.27 | $246.84 |