| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $14.82 | $14.82 | $14.82 | |
Aetna
| Professional | $14.82 | $14.82 | $144.65 | |
Anthem BCBS
| Facility | $168.65 | $168.65 | $168.65 | |
Cigna
| Facility | $90.60 | $90.60 | $90.60 | |
Cigna
| Professional | $130.77 | $130.77 | $130.77 |