| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $63.00 | $63.00 | $63.00 | |
Anthem BCBS
| Facility | $0.02 | $0.02 | $0.02 | |
Anthem BCBS
| Professional | $0.02 | $1.00 | $1.00 | |
CareSource
| Facility | $3.92 | $3.92 | $4.79 | |
CareSource
| Professional | $3.92 | $3.92 | $4.88 |