| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $199.53 | $199.53 | $199.53 | |
Aetna
| Professional | $398.11 | $398.11 | $398.11 | |
Anthem BCBS
| Professional | $309.03 | $354.81 | $416.87 | |
DeanCare
| Facility | $851.14 | $1,047.13 | $1,380.38 | |
Medica
| Facility | $2,454.71 | $2,454.71 | $2,454.71 | |
Molina
| Professional | $50.12 | $64.57 | $70.79 | |
United
| Facility | $2,454.71 | $2,454.71 | $3,235.94 | |
United
| Professional | $371.54 | $371.54 | $870.96 |