| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $17.14 | $17.14 | $17.14 | |
Aetna
| Professional | $17.61 | $17.61 | $17.61 | |
Anthem BCBS
| Professional | $18.34 | $99,999.99 | $99,999.99 | |
United
| Professional | $21.17 | $21.17 | $50.31 |