| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $94.29 | $94.29 | $94.29 | |
Aetna
| Professional | $65.30 | $97.68 | $114.72 | |
BCBS
| Professional | $50.00 | $50.00 | $50.00 | |
Molina
| Professional | $17.00 | $21.25 | $50.00 | |
United
| Professional | $96.99 | $118.76 | $174.65 |