| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $40.00 | $40.00 | $40.00 | |
Aetna
| Professional | $40.00 | $40.00 | $40.00 | |
Anthem BCBS
| Facility | $126.41 | $126.41 | $243.97 | |
Anthem BCBS
| Professional | $72.93 | $126.41 | $170.29 | |
Cigna
| Professional | $166.86 | $166.86 | $166.86 |