| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1.00 | $1.00 | $1.00 | |
Aetna
| Professional | $1.00 | $1.00 | $3.02 | |
BCBS
| Professional | $117.49 | $125.89 | $151.36 | |
Medcost
| Facility | $1.20 | $1.51 | $151.36 | |
Molina
| Professional | $30.20 | $30.20 | $30.20 | |
United
| Professional | $107.15 | $125.89 | $125.89 |