| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $7.08 | $7.08 | $7.08 | |
Aetna
| Professional | $10.00 | $15.85 | $19.95 | |
BCBS
| Facility | $28.18 | $28.18 | $30.90 | |
BCBS
| Professional | $26.92 | $26.92 | $26.92 | |
Molina
| Professional | $19.95 | $25.12 | $58.88 |