| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $199.53 | $199.53 | $199.53 | |
Aetna
| Professional | $1,202.26 | $1,202.26 | $2,137.96 | |
Anthem BCBS
| Professional | $302.00 | $363.08 | $363.08 | |
DeanCare
| Facility | $3,388.44 | $4,168.69 | $5,495.41 | |
Molina
| Professional | $50.12 | $54.95 | $70.79 |