| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $268.83 | $268.83 | $469.40 | |
Aetna
| Professional | $89.23 | $302.49 | $469.40 | |
BCBS
| Facility | $367.50 | $367.50 | $404.25 | |
BCBS
| Professional | $350.00 | $350.00 | $350.00 | |
Molina
| Professional | $17.00 | $25.00 | $50.00 |