| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $350.00 | $350.00 | $350.00 | |
Anthem BCBS
| Professional | $0.23 | $0.23 | $0.23 | |
CareSource
| Facility | $66.51 | $66.51 | $86.22 | |
CareSource
| Professional | $66.51 | $79.81 | $99.77 |