| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $69.13 | $96.10 | $143.29 | |
Aetna
| Professional | $69.12 | $96.10 | $98.73 | |
Ambetter
| Professional | $46.50 | $75.00 | $75.00 | |
Anthem BCBS
| Professional | $0.02 | $0.05 | $0.05 | |
CareSource
| Facility | $244.22 | $253.26 | $316.58 | |
CareSource
| Professional | $189.95 | $293.06 | $366.32 | |
Cigna
| Professional | $20.93 | $20.93 | $20.93 |