| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.05 | $1.05 | $1.05 | |
Aetna
| Professional | $1.05 | $1.05 | $1.05 | |
BCBS
| Professional | $109.00 | $109.00 | $109.00 | |
Molina
| Professional | $60.00 | $85.00 | $1,500.00 | |
United
| Professional | $65.40 | $65.40 | $109.00 |