| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $138.91 | $138.91 | $3,195.00 | |
Aetna
| Professional | $138.91 | $138.91 | $138.91 | |
Anthem BCBS
| Professional | $40.21 | $41.28 | $41.29 | |
Medica
| Facility | $138.91 | $159.76 | $311.18 |