| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $7,799.00 | $9,062.00 | $21,886.00 | |
Aetna
| Professional | $9,062.00 | $9,062.00 | $9,062.00 | |
BCBS
| Facility | $89.26 | $165.82 | $264.11 | |
Molina
| Professional | $30.00 | $30.00 | $30.00 |