| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $83.93 | $94.00 | $103.28 | |
Aetna
| Professional | $68.13 | $83.93 | $83.93 | |
Anthem BCBS
| Professional | $78.98 | $78.98 | $78.98 | |
United
| Professional | $83.93 | $98.74 | $104.66 | |
Well Sense
| Professional | $83.93 | $92.32 | $117.50 |