| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $112.32 | $112.32 | $112.32 | |
Aetna
| Professional | $78.12 | $112.32 | $112.32 | |
Ambetter
| Professional | $38.70 | $51.60 | $69.37 | |
Anthem BCBS
| Professional | $0.02 | $0.02 | $0.02 | |
CareSource
| Facility | $244.22 | $244.22 | $316.58 | |
CareSource
| Professional | $189.95 | $280.85 | $329.69 | |
Cigna
| Professional | $2.00 | $2.00 | $2.00 |