| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $420.82 | $443.71 | $443.71 | |
BCBS
| Facility | $1,129.85 | $2,199.21 | $3,664.53 | |
Medcost
| Facility | $420.81 | $499.17 | $504.97 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |