| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $43.59 | $143.16 | $143.16 | |
BCBS
| Professional | $36.29 | $100.00 | $144.99 | |
Medcost
| Professional | $66.01 | $66.01 | $66.01 | |
Molina
| Professional | $25.45 | $35.14 | $53.77 | |
United
| Professional | $22.48 | $32.36 | $75.92 |