| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $41.38 | $78.62 | $109.48 | |
Aetna
| Professional | $41.38 | $41.38 | $42.38 | |
Anthem BCBS
| Facility | $0.03 | $0.03 | $0.03 | |
Anthem BCBS
| Professional | $42.28 | $42.28 | $42.28 | |
United
| Professional | $42.28 | $42.28 | $42.28 |