| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $155.18 | $155.18 | $155.18 | |
Aetna
| Professional | $155.18 | $155.18 | $155.18 | |
Anthem BCBS
| Professional | $52.50 | $63.00 | $77.00 | |
United
| Professional | $136.25 | $192.68 | $341.62 |