| 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
| Professional | $520.00 | $650.00 | $650.00 | |
CareSource
| Facility | $563.84 | $563.84 | $789.38 | |
CareSource
| Professional | $584.72 | $648.41 | $868.32 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Cigna
| Professional | $354.90 | $354.90 | $354.90 | |
Molina
| Professional | $45.00 | $45.00 | $3,000.00 |