| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $11.58 | $16.93 | $20.37 | |
Medcost
| Facility | $13.56 | $23.11 | $32.74 | |
Medcost
| Professional | $23.11 | $23.11 | $23.67 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 | |
United
| Professional | $29.00 | $37.00 | $61.00 |