| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $90.05 | $160.00 | $160.00 | |
Aetna
| Professional | $96.55 | $114.56 | $160.00 | |
Anthem BCBS
| Professional | $130.00 | $150.00 | $159.25 | |
CareSource
| Facility | $111.83 | $156.56 | $203.12 | |
CareSource
| Professional | $111.83 | $139.79 | $157.68 | |
Molina
| Professional | $45.00 | $45.00 | $45.00 |