| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $191.36 | $191.36 | $318.17 | |
Aetna
| Professional | $169.90 | $191.36 | $233.72 | |
Anthem BCBS
| Facility | $251.35 | $284.76 | $318.17 | |
Anthem BCBS
| Professional | $269.02 | $327.38 | $454.34 | |
CareSource
| Facility | $270.44 | $374.81 | $477.26 | |
CareSource
| Professional | $270.44 | $349.99 | $429.53 | |
Cigna
| Facility | $318.17 | $382.03 | $382.03 | |
Cigna
| Professional | $278.88 | $382.03 | $432.14 | |
United
| Professional | $171.75 | $273.88 | $404.17 |