| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $263.03 | $263.03 | $263.03 | |
Aetna
| Professional | $204.17 | $263.03 | $346.74 | |
Anthem BCBS
| Professional | $630.96 | $676.08 | $676.08 | |
Cigna
| Professional | $229.09 | $229.09 | $229.09 | |
Molina
| Professional | $44.67 | $44.67 | $44.67 |