| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $212.34 | $212.34 | $212.34 | |
Anthem BCBS
| Facility | $26.28 | $26.28 | $50.72 | |
Anthem BCBS
| Professional | $26.28 | $26.28 | $35.40 | |
CareSource
| Facility | $115.30 | $119.57 | $149.88 | |
CareSource
| Professional | $89.68 | $138.36 | $172.96 | |
Cigna
| Professional | $73.70 | $86.72 | $86.72 |