| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $292.37 | $292.37 | $400.00 | |
Aetna
| Professional | $201.46 | $292.37 | $292.37 | |
Anthem BCBS
| Professional | $542.00 | $623.29 | $984.27 | |
CareSource
| Facility | $12,970.10 | $12,970.10 | $16,024.22 | |
Molina
| Professional | $40.00 | $50.00 | $60.00 |