| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,374.87 | $2,374.87 | $2,374.87 | |
Aetna
| Professional | $95.00 | $2,374.87 | $2,374.87 | |
Anthem BCBS
| Facility | $124.22 | $124.22 | $239.74 | |
Anthem BCBS
| Professional | $106.48 | $124.22 | $167.34 | |
Cigna
| Professional | $163.97 | $163.97 | $163.97 |