| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $441.00 | $441.00 | $441.00 | |
Anthem BCBS
| Facility | $0.16 | $0.16 | $0.16 | |
Anthem BCBS
| Professional | $0.11 | $0.14 | $0.14 | |
CareSource
| Facility | $174.38 | $44,449.56 | $52,149.48 | |
CareSource
| Professional | $43,499.57 | $48,999.51 | $50,749.49 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Molina
| Professional | $45.00 | $45.00 | $45.00 |