| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $121.78 | $121.78 | $121.78 | |
Aetna
| Professional | $121.78 | $144.43 | $166.35 | |
Anthem BCBS
| Facility | $386.00 | $386.00 | $744.98 | |
Anthem BCBS
| Professional | $308.80 | $386.00 | $532.67 | |
Cigna
| Professional | $166.68 | $166.68 | $166.68 |