| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $200.00 | $200.00 | $200.00 | |
Aetna
| Professional | $1,059.21 | $1,059.21 | $1,059.21 | |
Anthem BCBS
| Professional | $362.47 | $362.47 | $423.88 | |
Molina
| Professional | $50.00 | $55.00 | $70.00 |