| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $264.52 | $264.52 | $264.52 | |
Aetna
| Professional | $241.63 | $264.52 | $264.52 | |
Anthem BCBS
| Professional | $571.20 | $672.00 | $672.00 | |
Molina
| Professional | $45.00 | $45.00 | $45.00 |