| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $270.89 | $270.89 | $270.89 | |
Aetna
| Professional | $184.67 | $270.89 | $274.39 | |
BCBS
| Facility | $1,430.30 | $1,430.30 | $1,907.06 | |
Medcost
| Facility | $158.88 | $252.74 | $428.99 | |
Molina
| Professional | $55.00 | $55.00 | $55.00 |