| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $645.65 | $977.24 | $977.24 | |
Aetna
| Professional | $645.65 | $645.65 | $1,819.70 | |
Anthem BCBS
| Professional | $389.05 | $489.78 | $794.33 | |
Molina
| Professional | $39.81 | $50.12 | $60.26 | |
SummaCare
| Professional | $50.12 | $60.26 | $75.86 |