| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2.81 | $2.81 | $2.81 | |
Aetna
| Professional | $2.81 | $2.81 | $2.81 | |
Anthem BCBS
| Facility | $124.00 | $124.00 | $239.32 | |
Anthem BCBS
| Professional | $61.60 | $124.00 | $171.12 | |
Cigna
| Professional | $99.00 | $99.00 | $163.68 |