| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $376.69 | $376.69 | $376.69 | |
Aetna
| Professional | $376.69 | $376.69 | $376.69 | |
BCBS
| Facility | $329.94 | $1,209.82 | $1,971.39 | |
Molina
| Professional | $224.02 | $224.02 | $224.02 |