| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $58.88 | $58.88 | $58.88 | |
Aetna
| Professional | $58.88 | $58.88 | $58.88 | |
Anthem BCBS
| Professional | $562.34 | $562.34 | $562.34 | |
Cigna
| Facility | $524.81 | $524.81 | $524.81 | |
Cigna
| Professional | $446.68 | $524.81 | $524.81 | |
Medcost
| Facility | $58.88 | $58.88 | $74.13 |