| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $136.47 | $140.00 | $140.00 | |
Aetna
| Professional | $140.00 | $140.00 | $140.00 | |
Anthem BCBS
| Professional | $229.20 | $266.75 | $266.75 | |
CareSource
| Facility | $329.61 | $439.40 | $676.67 | |
CareSource
| Professional | $347.92 | $457.79 | $604.28 | |
Cigna
| Facility | $223.29 | $223.29 | $285.00 | |
Cigna
| Professional | $163.00 | $163.00 | $226.54 | |
Molina
| Professional | $222.44 | $271.27 | $325.53 | |
United
| Professional | $113.76 | $170.65 | $241.75 |