| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $250.88 | $250.88 | $250.88 | |
Aetna
| Professional | $229.94 | $250.88 | $250.88 | |
Anthem BCBS
| Professional | $48.13 | $64.18 | $79.65 | |
United
| Professional | $171.32 | $266.54 | $585.53 |