| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $174.10 | $174.10 | $174.10 | |
Aetna
| Professional | $89.88 | $174.10 | $249.99 | |
Anthem BCBS
| Professional | $237.49 | $246.81 | $249.99 | |
Cigna
| Professional | $161.72 | $161.72 | $161.72 |