| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $163.40 | $163.40 | $285.31 | |
Aetna
| Professional | $163.40 | $203.13 | $285.31 | |
BCBS
| Facility | $315.00 | $315.00 | $346.50 | |
BCBS
| Professional | $300.00 | $300.00 | $300.00 | |
Molina
| Professional | $17.00 | $25.00 | $50.00 |