| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $81.00 | $81.00 | $81.00 | |
Anthem BCBS
| Professional | $34.90 | $41.06 | $41.07 | |
CareSource
| Facility | $90.17 | $90.17 | $90.17 | |
CareSource
| Professional | $66.79 | $74.06 | $90.17 | |
Molina
| Professional | $45.00 | $45.00 | $45.00 |