| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $12.98 | $12.98 | $12.98 | |
Aetna
| Professional | $12.98 | $20.29 | $22.66 | |
BCBS
| Facility | $188.93 | $188.93 | $188.93 | |
BCBS
| Professional | $76.00 | $76.00 | $76.00 | |
Molina
| Professional | $17.00 | $25.00 | $50.00 | |
United
| Professional | $34.00 | $41.00 | $44.00 |