| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $88.76 | $88.76 | $95.00 | |
Aetna
| Professional | $88.76 | $88.76 | $88.76 | |
Anthem BCBS
| Professional | $30.00 | $38.94 | $72.56 | |
CareSource
| Facility | $127.35 | $127.35 | $155.63 | |
Molina
| Professional | $60.00 | $60.00 | $60.00 |