| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $171.15 | $171.15 | $171.15 | |
Aetna
| Professional | $171.15 | $171.15 | $289.19 | |
Anthem BCBS
| Professional | $372.22 | $379.73 | $391.82 | |
Cigna
| Professional | $413.59 | $413.59 | $413.59 |