| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $213.80 | $218.78 | $218.78 | |
Aetna
| Professional | $67.61 | $158.49 | $218.78 | |
Anthem BCBS
| Professional | $269.15 | $316.23 | $478.63 | |
Molina
| Professional | $39.81 | $50.12 | $60.26 | |
SummaCare
| Professional | $60.26 | $60.26 | $75.86 |