| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $109.65 | $109.65 | $109.65 | |
Aetna
| Professional | $93.33 | $117.49 | $134.90 | |
BCBS
| Professional | $54.95 | $54.95 | $54.95 | |
Molina
| Professional | $21.38 | $25.12 | $50.12 | |
United
| Professional | $107.15 | $125.89 | $134.90 |