| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $2.00 | $2.00 | $2.00 | |
Anthem BCBS
| Professional | $0.02 | $181.97 | $251.19 | |
Molina
| Professional | $50.12 | $50.12 | $50.12 | |
SummaCare
| Professional | $60.26 | $60.26 | $60.26 |