| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3.00 | $3.00 | $3.00 | |
Aetna
| Professional | $3.00 | $3.00 | $3.00 | |
Anthem BCBS
| Professional | $0.02 | $0.02 | $4.59 | |
CareSource
| Facility | $66.51 | $59,702.01 | $59,702.01 | |
CareSource
| Professional | $66.51 | $66.51 | $66.51 | |
Molina
| Professional | $30.00 | $30.00 | $50.00 |