| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $177.88 | $185.88 | $185.88 | |
Aetna
| Professional | $154.90 | $185.88 | $214.06 | |
Ambetter
| Professional | $202.20 | $202.20 | $202.20 | |
Anthem BCBS
| Professional | $121.28 | $161.71 | $217.85 | |
CareSource
| Facility | $247.40 | $250.94 | $306.70 | |
CareSource
| Professional | $202.31 | $250.94 | $313.67 | |
Cigna
| Professional | $45.05 | $45.05 | $213.46 | |
United
| Professional | $161.71 | $161.71 | $161.71 |