| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $44.67 | $44.67 | $44.67 | |
Aetna
| Professional | $44.67 | $44.67 | $44.67 | |
Anthem BCBS
| Professional | $218.78 | $1,071.52 | $1,071.52 | |
Cigna
| Facility | $380.19 | $380.19 | $380.19 | |
Cigna
| Professional | $275.42 | $275.42 | $380.19 | |
Medica
| Facility | $44.67 | $51.29 | $100.00 | |
Medica
| Professional | $44.67 | $44.67 | $44.67 | |
United
| Facility | $489.78 | $489.78 | $489.78 |