| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,792.34 | $1,792.34 | $1,792.34 | |
Aetna
| Professional | $1,763.19 | $1,796.21 | $2,018.05 | |
BCBS
| Professional | $150.00 | $150.00 | $150.00 | |
Molina
| Professional | $40.00 | $1,000.00 | $1,812.15 |