| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $19.60 | $19.60 | $34.22 | |
Aetna
| Professional | $19.60 | $31.12 | $34.22 | |
BCBS
| Facility | $42.00 | $42.00 | $46.20 | |
BCBS
| Professional | $40.00 | $40.00 | $40.00 | |
Molina
| Professional | $17.00 | $25.00 | $50.00 |