| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $660.98 | $660.98 | $660.98 | |
BCBS
| Facility | $0.02 | $0.06 | $0.09 | |
Health Alliance Plan
| Professional | $660.98 | $660.98 | $660.98 | |
Molina
| Professional | $30.00 | $30.00 | $100.00 |