| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $175.28 | $175.28 | $175.28 | |
Aetna
| Professional | $143.75 | $175.28 | $175.28 | |
Anthem BCBS
| Professional | $22.50 | $30.00 | $33.00 | |
Cigna
| Professional | $148.66 | $148.66 | $178.12 |