| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $872.00 | $872.00 | $872.00 | |
Anthem BCBS
| Facility | $32.00 | $32.00 | $88.50 | |
Anthem BCBS
| Professional | $21.16 | $32.00 | $44.16 | |
CareSource
| Facility | $43,749.56 | $65,624.35 | $89,999.10 |