| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $54.53 | $214.40 | $577.52 | |
Aetna
| Professional | $37.64 | $57.50 | $65.72 | |
BCBS
| Facility | $593.75 | $593.75 | $593.75 | |
BCBS
| Professional | $100.00 | $100.00 | $100.00 | |
Molina
| Professional | $21.25 | $42.50 | $50.00 |