| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $32.36 | $32.36 | $32.36 | |
Aetna
| Professional | $14.13 | $25.12 | $32.36 | |
Medcost
| Facility | $19.50 | $33.11 | $67.61 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 | |
United
| Professional | $2.57 | $16.22 | $38.90 |