| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $506.01 | $506.01 | $506.01 | |
Aetna
| Professional | $506.01 | $506.01 | $506.01 | |
Anthem BCBS
| Professional | $255.84 | $337.55 | $932.04 | |
CareSource
| Facility | $48,999.51 | $52,499.48 | $61,249.39 | |
United
| Professional | $314.01 | $355.10 | $480.69 |