| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $32.36 | $32.36 | $32.36 | |
Aetna
| Professional | $32.36 | $32.36 | $33.88 | |
Anthem BCBS
| Professional | $25.12 | $25.12 | $81.28 | |
SummaCare
| Professional | $60.26 | $60.26 | $60.26 | |
United
| Professional | $32.36 | $33.88 | $40.74 |