| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $436.52 | $436.52 | $436.52 | |
Aetna
| Professional | $436.52 | $436.52 | $436.52 | |
Anthem BCBS
| Professional | $0.14 | $0.15 | $0.32 | |
Molina
| Professional | $81.28 | $131.83 | $177.83 | |
SummaCare
| Professional | $60.26 | $60.26 | $60.26 | |
United
| Professional | $0.98 | $0.98 | $0.98 |