| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $112.20 | $112.20 | $2,137.96 | |
Aetna
| Professional | $104.71 | $109.65 | $112.20 | |
Anthem BCBS
| Professional | $0.02 | $0.02 | $69.18 | |
Cigna
| Facility | $112.20 | $112.20 | $112.20 | |
Cigna
| Professional | $112.20 | $112.20 | $112.20 | |
Medcost
| Facility | $104.71 | $112.20 | $190.55 |