| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $57.54 | $57.54 | $57.54 | |
Aetna
| Professional | $57.54 | $57.54 | $107.15 | |
Anthem BCBS
| Professional | $30.20 | $144.54 | $144.54 | |
Cigna
| Professional | $158.49 | $158.49 | $158.49 |