| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $22.31 | $22.31 | $22.31 | |
Anthem BCBS
| Professional | $22.31 | $65.89 | $99,999.99 | |
Cigna
| Facility | $174.33 | $174.33 | $174.33 | |
Cigna
| Professional | $174.33 | $174.33 | $174.33 | |
Martin's Point
| Professional | $22.31 | $22.31 | $22.31 | |
United
| Professional | $91.71 | $125.03 | $312.58 |