| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,768.95 | $3,768.95 | $3,768.95 | |
Aetna
| Professional | $3,768.95 | $3,768.95 | $3,768.95 | |
Anthem BCBS
| Professional | $0.03 | $0.03 | $0.03 | |
United
| Professional | $50.00 | $50.00 | $50.00 |