| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $123.00 | $135.00 | $138.00 | |
Aetna
| Professional | $123.00 | $137.00 | $143.00 | |
Anthem BCBS
| Professional | $26.00 | $26.00 | $41.60 | |
CareSource
| Facility | $30.77 | $30.77 | $59,702.01 |