| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $107.15 | $107.15 | $107.15 | |
Aetna
| Professional | $93.33 | $112.20 | $190.55 | |
Anthem BCBS
| Professional | $117.49 | $117.49 | $117.49 | |
Select Health
| Professional | $645.65 | $645.65 | $660.69 |