| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $751.56 | $751.56 | $751.56 | |
Aetna
| Professional | $751.56 | $751.56 | $751.56 | |
Anthem BCBS
| Professional | $0.02 | $0.03 | $0.03 | |
Cigna
| Professional | $477.77 | $477.77 | $477.77 |