| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $118.13 | $130.08 | $130.08 | |
Aetna
| Professional | $118.13 | $130.08 | $130.79 | |
Ambetter
| Professional | $112.00 | $112.00 | $112.00 | |
Anthem BCBS
| Professional | $0.02 | $0.05 | $0.05 | |
CareSource
| Facility | $327.63 | $339.77 | $424.71 | |
CareSource
| Professional | $254.82 | $393.16 | $491.45 | |
Cigna
| Professional | $13.17 | $13.17 | $13.17 |