| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $107.15 | $131.83 | $131.83 | |
Anthem BCBS
| Professional | $38.02 | $38.02 | $38.02 | |
Well Sense
| Facility | $2,511.89 | $3,388.44 | $4,168.69 | |
Well Sense
| Professional | $2,511.89 | $2,511.89 | $2,511.89 |