| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $64.00 | $64.00 | $64.00 | |
DeanCare
| Facility | $0.02 | $0.02 | $0.02 | |
Medica
| Facility | $0.02 | $0.02 | $0.02 | |
Molina
| Professional | $50.00 | $60.00 | $85.00 | |
Prevea360
| Facility | $0.02 | $0.02 | $0.02 | |
Quartz
| Facility | $65.00 | $65.00 | $65.00 |