| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $118.94 | $118.94 | $207.67 | |
Aetna
| Professional | $118.94 | $179.46 | $231.88 | |
BCBS
| Facility | $593.75 | $593.75 | $593.75 | |
BCBS
| Professional | $630.00 | $630.00 | $630.00 | |
Molina
| Professional | $17.00 | $21.25 | $50.00 |