| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $142.26 | $142.26 | $142.26 | |
Aetna
| Professional | $110.15 | $142.26 | $142.26 | |
Ambetter
| Professional | $62.75 | $62.75 | $91.55 | |
Anthem BCBS
| Professional | $0.02 | $0.02 | $0.02 | |
CareSource
| Facility | $327.63 | $327.63 | $424.71 | |
CareSource
| Professional | $254.82 | $376.78 | $442.30 | |
Cigna
| Professional | $66.00 | $66.00 | $66.00 |