| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $251.00 | $251.00 | $251.00 | |
Anthem BCBS
| Facility | $34.85 | $34.85 | $67.26 | |
Anthem BCBS
| Professional | $28.22 | $39.00 | $54.70 | |
CareSource
| Facility | $52,499.48 | $52,499.48 | $52,499.48 |