| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $25.70 | $40.74 | $91.20 | |
Anthem BCBS
| Facility | $43.65 | $43.65 | $43.65 | |
Anthem BCBS
| Professional | $43.65 | $43.65 | $91.20 | |
Select Health
| Professional | $64.57 | $64.57 | $67.61 |