| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $114.82 | $5,011.87 | $5,011.87 | |
Aetna
| Professional | $114.82 | $120.23 | $123.03 | |
Anthem BCBS
| Professional | $44.67 | $44.67 | $123.03 | |
Cigna
| Facility | $123.03 | $123.03 | $123.03 |