| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $14.13 | $14.13 | $14.13 | |
Aetna
| Professional | $14.13 | $14.13 | $144.54 | |
Anthem BCBS
| Professional | $3.80 | $3.80 | $3.80 | |
Cigna
| Facility | $64.57 | $64.57 | $64.57 | |
Cigna
| Professional | $131.83 | $131.83 | $131.83 |