| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $113.46 | $113.46 | $198.11 | |
Aetna
| Professional | $73.12 | $113.46 | $198.11 | |
BCBS
| Facility | $157.50 | $157.50 | $173.25 | |
BCBS
| Professional | $150.00 | $150.00 | $150.00 | |
Molina
| Professional | $17.00 | $25.00 | $50.00 |