| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $28.04 | $28.04 | $48.95 | |
Aetna
| Professional | $28.04 | $44.50 | $48.95 | |
BCBS
| Facility | $126.00 | $126.00 | $138.60 | |
BCBS
| Professional | $120.00 | $120.00 | $120.00 | |
Molina
| Professional | $17.00 | $25.00 | $50.00 |