| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $108.09 | $112.05 | $112.05 | |
Anthem BCBS
| Professional | $28.50 | $28.50 | $68.94 | |
Cigna
| Facility | $112.05 | $112.05 | $112.05 | |
Cigna
| Professional | $112.05 | $112.05 | $112.05 | |
Martin's Point
| Professional | $112.05 | $112.05 | $112.05 |