| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $468.00 | $468.00 | $468.00 | |
Anthem BCBS
| Facility | $23.09 | $23.09 | $44.56 | |
Anthem BCBS
| Professional | $23.09 | $23.09 | $53.00 | |
CareSource
| Facility | $264.24 | $264.24 | $264.24 | |
Cigna
| Professional | $30.48 | $30.48 | $30.48 |