| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $107.42 | $204.10 | $284.17 | |
Aetna
| Professional | $107.42 | $107.42 | $110.01 | |
Anthem BCBS
| Professional | $100.74 | $110.01 | $111.85 | |
United
| Professional | $84.12 | $129.41 | $129.41 |