| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $171.96 | $171.96 | $171.96 | |
Aetna
| Professional | $171.96 | $171.96 | $332.76 | |
Anthem BCBS
| Facility | $650.00 | $650.00 | $1,254.50 | |
Anthem BCBS
| Professional | $520.00 | $650.00 | $880.37 | |
CareSource
| Facility | $563.84 | $584.72 | $732.99 | |
CareSource
| Professional | $438.54 | $676.61 | $845.76 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $93.32 | $858.00 | $858.00 |