| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $187.57 | $187.57 | $187.57 | |
Aetna
| Professional | $176.54 | $187.57 | $187.57 | |
Anthem BCBS
| Facility | $141.88 | $194.39 | $417.58 | |
Anthem BCBS
| Professional | $0.02 | $0.02 | $163.60 | |
Cigna
| Facility | $141.22 | $187.57 | $269.00 | |
Cigna
| Professional | $187.57 | $187.57 | $187.57 | |
Medcost
| Facility | $183.16 | $187.57 | $316.99 |