| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $125.89 | $125.89 | $125.89 | |
Aetna
| Professional | $81.28 | $125.89 | $138.04 | |
Anthem BCBS
| Professional | $23.44 | $125.89 | $125.89 | |
Select Health
| Professional | $120.23 | $128.82 | $131.83 | |
United
| Professional | $125.89 | $125.89 | $128.82 |