| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3.44 | $3.44 | $3.44 | |
Aetna
| Professional | $3.44 | $3.44 | $3.50 | |
Anthem BCBS
| Facility | $193.04 | $193.04 | $193.04 | |
Cigna
| Facility | $103.70 | $103.70 | $103.70 | |
Cigna
| Professional | $119.56 | $119.56 | $119.56 |