| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $78.28 | $78.28 | $4,846.00 | |
Anthem BCBS
| Facility | $167.72 | $167.72 | $323.70 | |
CareSource
| Facility | $80.25 | $105.55 | $158.33 | |
United
| Facility | $933.00 | $2,252.00 | $4,426.00 |