| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $79.43 | $79.43 | $138.04 | |
Aetna
| Professional | $79.43 | $123.03 | $257.04 | |
BCBS
| Facility | $588.84 | $588.84 | $588.84 | |
BCBS
| Professional | $234.42 | $234.42 | $234.42 | |
Molina
| Professional | $21.38 | $38.02 | $50.12 |