| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $24.37 | $24.37 | $24.37 | |
Aetna
| Professional | $24.37 | $24.37 | $24.37 | |
Anthem BCBS
| Professional | $21.25 | $25.00 | $72.90 | |
CareSource
| Facility | $24.16 | $29,749.70 | $97,999.02 | |
United
| Professional | $24.07 | $24.16 | $29.84 |