| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $0.73 | $0.73 | $0.73 | |
Aetna
| Professional | $0.73 | $0.73 | $6.21 | |
BCBS
| Professional | $6.20 | $6.20 | $6.20 | |
Medcost
| Facility | $0.73 | $0.80 | $0.92 | |
Medcost
| Professional | $0.72 | $0.72 | $0.72 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |