| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $88.76 | $88.76 | $88.76 | |
Anthem BCBS
| Professional | $30.00 | $72.56 | $72.56 | |
DeanCare
| Facility | $88.76 | $88.76 | $88.76 | |
Medica
| Facility | $88.76 | $88.76 | $747.98 | |
Molina
| Professional | $50.00 | $58.40 | $70.00 | |
Prevea360
| Facility | $88.76 | $88.76 | $88.76 |