| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $93.33 | $93.33 | $93.33 | |
Aetna
| Professional | $91.66 | $93.33 | $93.33 | |
Anthem BCBS
| Facility | $623.44 | $829.48 | $1,481.20 | |
Anthem BCBS
| Professional | $189.59 | $313.20 | $445.73 |