| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,082.00 | $1,151.72 | $1,151.72 | |
Aetna
| Professional | $420.82 | $1,151.72 | $1,151.72 | |
Anthem BCBS
| Professional | $8.01 | $8.01 | $9.61 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |