| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $184.38 | $184.38 | $184.38 | |
Aetna
| Professional | $184.38 | $184.38 | $221.34 | |
Anthem BCBS
| Facility | $2,101.36 | $2,101.36 | $2,101.36 | |
Cigna
| Facility | $1,128.83 | $1,128.83 | $1,128.83 |