| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $105.28 | $105.28 | $164.71 | |
Aetna
| Professional | $105.28 | $111.04 | $360.00 | |
Anthem BCBS
| Facility | $94.55 | $94.55 | $94.55 | |
Anthem BCBS
| Professional | $16.97 | $23.50 | $48.01 |