| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $113.05 | $195.00 | $195.00 | |
Aetna
| Professional | $115.83 | $140.32 | $195.00 | |
Anthem BCBS
| Professional | $163.00 | $185.00 | $185.00 | |
Molina
| Professional | $45.00 | $45.00 | $45.00 |