| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $161.84 | $161.84 | $282.57 | |
Aetna
| Professional | $161.84 | $256.88 | $282.57 | |
BCBS
| Facility | $616.35 | $616.35 | $677.99 | |
BCBS
| Professional | $587.00 | $587.00 | $587.00 | |
Molina
| Professional | $21.25 | $42.50 | $50.00 |