| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $127.52 | $127.52 | $127.52 | |
Aetna
| Professional | $124.45 | $127.52 | $131.28 | |
Anthem BCBS
| Professional | $127.50 | $150.00 | $150.00 | |
Molina
| Professional | $45.00 | $45.00 | $45.00 |