| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $93.33 | $93.33 | $93.33 | |
Aetna
| Professional | $61.66 | $102.33 | $117.49 | |
BCBS
| Professional | $66.07 | $66.07 | $66.07 | |
Molina
| Professional | $21.38 | $38.02 | $67.61 | |
United
| Professional | $89.13 | $112.20 | $173.78 |