| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $70.00 | $70.00 | $70.00 | |
Aetna
| Professional | $70.00 | $70.00 | $70.00 | |
Anthem BCBS
| Facility | $0.02 | $0.02 | $0.02 | |
Anthem BCBS
| Professional | $0.02 | $121.98 | $121.98 | |
Cigna
| Professional | $51.00 | $51.00 | $51.00 |