| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $11.34 | $11.34 | $11.34 | |
Aetna
| Professional | $11.34 | $11.34 | $11.34 | |
Anthem BCBS
| Facility | $191.00 | $283.00 | $874.00 | |
Anthem BCBS
| Professional | $24.54 | $25.12 | $89.10 | |
Cigna
| Professional | $17.84 | $17.84 | $17.84 | |
United
| Professional | $25.20 | $36.45 | $49.29 |