| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $123.03 | $123.03 | $213.80 | |
Aetna
| Professional | $162.18 | $190.55 | $239.88 | |
BCBS
| Facility | $208.93 | $208.93 | $229.09 | |
BCBS
| Professional | $169.82 | $169.82 | $169.82 | |
Molina
| Professional | $21.38 | $38.02 | $50.12 |