| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $9.77 | $184.22 | $214.96 | |
Aetna
| Professional | $6.63 | $10.51 | $12.91 | |
BCBS
| Facility | $21.00 | $21.00 | $23.10 | |
BCBS
| Professional | $20.00 | $20.00 | $20.00 | |
Molina
| Professional | $21.25 | $42.50 | $68.00 |