| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $27.73 | $157.32 | $157.32 | |
Aetna
| Professional | $27.73 | $44.70 | $66.13 | |
BCBS
| Facility | $100.80 | $100.80 | $110.88 | |
BCBS
| Professional | $96.00 | $96.00 | $96.00 | |
Molina
| Professional | $21.25 | $42.50 | $68.00 |