| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.00 | $1.20 | $1.20 | |
Aetna
| Professional | $1.00 | $1.00 | $1.20 | |
Anthem BCBS
| Facility | $125.89 | $288.40 | $512.86 | |
Anthem BCBS
| Professional | $97.72 | $97.72 | $151.36 | |
Cigna
| Professional | $97.72 | $128.82 | $186.21 | |
United
| Professional | $125.89 | $125.89 | $125.89 |