| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $299.74 | $299.74 | $299.74 | |
Aetna
| Professional | $299.74 | $299.74 | $369.32 | |
Ambetter
| Professional | $64.50 | $64.50 | $64.50 | |
BCBS
| Professional | $35.00 | $36.75 | $50.67 | |
Medcost
| Facility | $299.74 | $308.73 | $461.60 | |
Molina
| Professional | $17.00 | $55.00 | $71.53 |