| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $70.00 | $70.00 | $70.00 | |
Aetna
| Professional | $70.00 | $70.00 | $70.00 | |
BCBS
| Professional | $62.50 | $68.38 | $111.17 | |
Medcost
| Facility | $29.07 | $43.61 | $80.50 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |