| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $586.25 | $1,246.70 | $1,276.34 | |
Aetna
| Professional | $855.25 | $855.25 | $916.34 | |
BCBS
| Facility | $971.78 | $2,066.92 | $3,664.53 | |
Medcost
| Facility | $855.25 | $940.78 | $1,453.93 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |