| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $163.43 | $296.42 | $296.42 | |
Aetna
| Professional | $216.25 | $292.37 | $296.42 | |
Anthem BCBS
| Professional | $300.00 | $460.70 | $542.00 | |
Molina
| Professional | $45.00 | $45.00 | $45.00 |