| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $213.80 | $213.80 | $213.80 | |
Aetna
| Professional | $213.80 | $213.80 | $213.80 | |
Anthem BCBS
| Professional | $26.30 | $64.57 | $64.57 | |
Select Health
| Professional | $89.13 | $89.13 | $89.13 |