| 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 | $184.38 | |
Anthem BCBS
| Professional | $0.02 | $0.02 | $0.02 | |
Cigna
| Professional | $71.28 | $71.28 | $71.28 | |
Medcost
| Facility | $184.38 | $265.51 | $337.42 |