| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $252.64 | $252.64 | $252.64 | |
Anthem BCBS
| Facility | $31.94 | $31.94 | $31.94 | |
Anthem BCBS
| Professional | $31.94 | $31.94 | $31.94 | |
CareSource
| Facility | $140.13 | $140.13 | $196.20 | |
CareSource
| Professional | $145.33 | $161.16 | $215.82 | |
Molina
| Professional | $45.00 | $45.00 | $3,000.00 |