| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $79.09 | $79.09 | $79.09 | |
Aetna
| Professional | $3,000.00 | $3,000.00 | $3,000.00 | |
BCBS
| Facility | $82.33 | $82.33 | $82.33 | |
BCBS
| Professional | $76.09 | $85.30 | $108.12 | |
Health Alliance Plan
| Facility | $79.09 | $79.09 | $79.09 | |
Health Alliance Plan
| Professional | $303.00 | $303.00 | $3,000.00 | |
Molina
| Professional | $100.00 | $100.00 | $100.00 |