| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $245.47 | $245.47 | $245.47 | |
Anthem BCBS
| Facility | $2,818.38 | $4,466.84 | $8,709.64 | |
Anthem BCBS
| Professional | $0.02 | $0.02 | $0.02 | |
CareSource
| Facility | $60,255.96 | $74,131.02 | $75,857.76 | |
United
| Facility | $194.98 | $2,137.96 | $5,754.40 |