| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $125.89 | $125.89 | $125.89 | |
Aetna
| Professional | $67.61 | $97.72 | $128.82 | |
Anthem BCBS
| Facility | $60.26 | $60.26 | $117.49 | |
Anthem BCBS
| Professional | $60.26 | $81.28 | $131.83 | |
CareSource
| Facility | $147.91 | $190.55 | $218.78 | |
Cigna
| Professional | $60.26 | $60.26 | $97.72 | |
United
| Professional | $41.69 | $70.79 | $102.33 |