| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $140.21 | $140.21 | $140.21 | |
Aetna
| Professional | $92.13 | $140.21 | $141.44 | |
BCBS
| Facility | $1,430.30 | $1,430.30 | $1,907.06 | |
Medcost
| Facility | $79.54 | $126.38 | $222.51 | |
Molina
| Professional | $55.00 | $55.00 | $55.00 |