| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $973.77 | $973.77 | $973.77 | |
Aetna
| Professional | $973.77 | $973.77 | $1,194.00 | |
Anthem BCBS
| Professional | $15.30 | $20.39 | $30.00 | |
United
| Professional | $1,345.16 | $1,345.16 | $1,345.16 |