| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $30.00 | $30.00 | $30.00 | |
Aetna
| Professional | $30.00 | $30.00 | $30.00 | |
Anthem BCBS
| Facility | $596.00 | $673.00 | $796.00 | |
Anthem BCBS
| Professional | $187.92 | $233.50 | $256.85 |