| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $80.06 | $80.06 | $332.03 | |
Aetna
| Professional | $80.06 | $80.06 | $80.06 | |
Anthem BCBS
| Professional | $30.00 | $30.00 | $30.00 | |
Medica
| Facility | $80.06 | $92.07 | $187.04 | |
Medica
| Professional | $175.50 | $175.50 | $175.50 | |
United
| Facility | $117.84 | $117.84 | $126.21 |