| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $304.62 | $304.62 | $304.62 | |
Aetna
| Professional | $264.44 | $304.62 | $304.62 | |
Anthem BCBS
| Professional | $1,335.46 | $1,571.13 | $1,769.50 | |
Molina
| Professional | $45.00 | $45.00 | $45.00 |