| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $176.47 | $335.29 | $466.83 | |
Aetna
| Professional | $176.47 | $176.47 | $180.72 | |
Anthem BCBS
| Professional | $180.30 | $180.72 | $225.00 | |
United
| Professional | $180.30 | $180.30 | $180.30 |