| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $574.00 | $574.00 | $574.00 | |
Aetna
| Professional | $574.00 | $574.00 | $574.00 | |
Anthem BCBS
| Professional | $292.00 | $292.00 | $365.00 | |
CareSource
| Facility | $170.10 | $170.10 | $170.10 | |
Cigna
| Facility | $424.00 | $424.00 | $424.00 | |
Cigna
| Professional | $360.40 | $424.00 | $424.00 |