| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $64.57 | $158.49 | $158.49 | |
Aetna
| Professional | $61.66 | $64.57 | $158.49 | |
Anthem BCBS
| Professional | $3.80 | $3.80 | $3.80 | |
SummaCare
| Facility | $120.23 | $120.23 | $120.23 | |
United
| Facility | $77.62 | $77.62 | $234.42 |