| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $707.95 | $707.95 | $707.95 | |
Aetna
| Professional | $707.95 | $707.95 | $707.95 | |
Anthem BCBS
| Professional | $66.07 | $66.07 | $72.44 | |
Medica
| Facility | $707.95 | $724.44 | $1,479.11 | |
United
| Facility | $44.67 | $44.67 | $173.78 |