| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $114.82 | $194.98 | $338.84 | |
Aetna
| Professional | $95.50 | $114.82 | $138.04 | |
Anthem BCBS
| Facility | $128.82 | $141.25 | $151.36 | |
Anthem BCBS
| Professional | $5.01 | $5.89 | $5.89 | |
CareSource
| Facility | $169.82 | $2,089.30 | $41,686.94 | |
CareSource
| Professional | $158.49 | $199.53 | $2,630.27 | |
Cigna
| Facility | $93.33 | $229.09 | $229.09 | |
Cigna
| Professional | $691.83 | $691.83 | $691.83 | |
Molina
| Professional | $100.00 | $100.00 | $100.00 | |
United
| Professional | $60.26 | $85.11 | $141.25 |