| 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 | $31.50 | |
Anthem BCBS
| Facility | $408.80 | $617.85 | $1,021.02 | |
Anthem BCBS
| Professional | $233.50 | $233.50 | $233.50 |