| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $153.41 | $153.41 | $153.41 | |
Aetna
| Professional | $115.91 | $151.62 | $153.41 | |
Anthem BCBS
| Professional | $133.44 | $157.00 | $157.00 | |
Molina
| Professional | $45.00 | $45.00 | $45.00 |