| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.00 | $1.32 | $1.62 | |
Aetna
| Professional | $1.00 | $1.00 | $1.62 | |
Molina
| Professional | $32.36 | $39.81 | $50.12 | |
United
| Professional | $3.31 | $3.31 | $54.95 | |
Wellpoint
| Professional | $8.13 | $8.13 | $8.13 |