| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $446.68 | $446.68 | $446.68 | |
Aetna
| Professional | $446.68 | $446.68 | $446.68 | |
Anthem BCBS
| Professional | $616.60 | $616.60 | $616.60 | |
Cigna
| Professional | $257.04 | $257.04 | $257.04 |