| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $206.72 | $206.72 | $206.72 | |
Aetna
| Professional | $206.72 | $206.72 | $206.72 | |
Anthem BCBS
| Professional | $51.81 | $51.81 | $85.65 | |
Medcost
| Facility | $206.72 | $287.33 | $363.83 |