| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $708.19 | $708.19 | $708.19 | |
Aetna
| Professional | $91.33 | $708.19 | $846.27 | |
Anthem BCBS
| Professional | $123.42 | $199.12 | $500.00 | |
CareSource
| Facility | $15,684.66 | $16,812.05 | $23,611.98 | |
Cigna
| Facility | $803.63 | $803.63 | $803.63 | |
Cigna
| Professional | $630.72 | $630.72 | $630.72 | |
United
| Professional | $67.18 | $130.13 | $336.56 |