| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $83.18 | $83.18 | $147.91 | |
Aetna
| Professional | $109.65 | $128.82 | $162.18 | |
BCBS
| Facility | $158.49 | $158.49 | $173.78 | |
BCBS
| Professional | $109.65 | $109.65 | $109.65 | |
Molina
| Professional | $21.38 | $38.02 | $50.12 |