| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $97.00 | $97.00 | $97.00 | |
Aetna
| Professional | $88.00 | $97.00 | $97.00 | |
Anthem BCBS
| Facility | $37.70 | $37.70 | $72.76 | |
Anthem BCBS
| Professional | $37.70 | $37.70 | $93.66 | |
Cigna
| Facility | $94.60 | $94.60 | $94.60 | |
Cigna
| Professional | $69.06 | $69.06 | $94.60 |