| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $253.60 | $253.60 | $253.60 | |
Anthem BCBS
| Professional | $23.76 | $23.76 | $26.40 | |
Martin's Point
| Professional | $253.60 | $253.60 | $253.60 | |
United
| Professional | $552.00 | $552.00 | $552.00 |