| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $837.90 | $837.90 | $837.90 | |
Aetna
| Professional | $3.00 | $3.00 | $3.00 | |
Anthem BCBS
| Professional | $3.44 | $4.59 | $4.59 | |
MVP Health Care
| Facility | $555.00 | $597.00 | $74,999.25 |