| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $252.64 | $252.64 | $270.00 | |
Aetna
| Professional | $252.64 | $252.64 | $252.64 | |
Anthem BCBS
| Professional | $31.94 | $36.25 | $52.34 | |
CareSource
| Facility | $140.13 | $140.13 | $171.29 | |
Molina
| Professional | $60.00 | $60.00 | $60.00 |