| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $138.04 | $138.04 | $138.04 | |
Aetna
| Professional | $114.82 | $120.23 | $138.04 | |
BCBS
| Facility | $56,234.13 | $69,183.10 | $81,283.05 | |
Molina
| Professional | $50.12 | $60.26 | $70.79 | |
Providence
| Facility | $114.82 | $123.03 | $309.03 |