| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $13.72 | $13.72 | $38.40 | |
Aetna
| Professional | $9.44 | $9.63 | $38.40 | |
Molina
| Professional | $40.00 | $40.00 | $50.00 | |
United
| Professional | $10.00 | $10.00 | $11.11 | |
Wellpoint
| Professional | $1.08 | $1.08 | $1.08 |