| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $9.60 | $9.60 | $9.60 | |
Anthem BCBS
| Professional | $13.00 | $13.00 | $13.00 | |
Martin's Point
| Professional | $9.60 | $9.60 | $9.60 | |
United
| Professional | $15.75 | $15.75 | $23.63 |