| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $290.94 | $290.94 | $290.94 | |
Aetna
| Professional | $143.10 | $268.56 | $349.07 | |
Anthem BCBS
| Facility | $280.10 | $280.10 | $540.59 | |
Anthem BCBS
| Professional | $224.08 | $280.10 | $378.13 | |
CareSource
| Facility | $39.36 | $58.02 | $72.53 | |
CareSource
| Professional | $45.06 | $54.07 | $63.08 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $35.88 | $66.81 | $66.81 | |
United
| Professional | $15.45 | $23.17 | $32.07 |