| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $122.54 | $122.54 | $122.54 | |
Aetna
| Professional | $103.40 | $122.54 | $122.54 | |
Anthem BCBS
| Professional | $117.15 | $117.15 | $306.74 | |
United
| Facility | $200.00 | $1,427.00 | $1,998.00 | |
United
| Professional | $154.40 | $198.01 | $277.93 |