| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $51.29 | $51.29 | $51.29 | |
Aetna
| Professional | $51.29 | $51.29 | $602.56 | |
Anthem BCBS
| Professional | $0.02 | $0.02 | $0.02 | |
Medcost
| Facility | $51.29 | $74.13 | $95.50 | |
United
| Facility | $54.95 | $204.17 | $645.65 |