| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $95.37 | $170.00 | $170.00 | |
Aetna
| Professional | $99.22 | $118.39 | $170.00 | |
Anthem BCBS
| Professional | $138.81 | $163.30 | $163.30 | |
Molina
| Professional | $45.00 | $45.00 | $45.00 |