| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $112.20 | $114.82 | $239.88 | |
Aetna
| Professional | $100.00 | $114.82 | $141.25 | |
Anthem BCBS
| Facility | $64.57 | $67.61 | $141.25 | |
Anthem BCBS
| Professional | $70.79 | $83.18 | $83.18 | |
CareSource
| Facility | $41,686.94 | $52,480.75 | $63,095.73 | |
CareSource
| Professional | $120.23 | $120.23 | $120.23 | |
Cigna
| Facility | $120.23 | $151.36 | $151.36 | |
Cigna
| Professional | $812.83 | $812.83 | $812.83 |