| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $91.90 | $91.90 | $91.90 | |
Aetna
| Professional | $91.90 | $106.45 | $131.72 | |
Anthem BCBS
| Professional | $29.00 | $33.10 | $43.00 | |
Cigna
| Facility | $64.00 | $64.00 | $64.00 | |
Martin's Point
| Professional | $91.90 | $106.45 | $196.00 |