| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $107.15 | $194.98 | $218.78 | |
Aetna
| Professional | $79.43 | $85.11 | $194.98 | |
BCBS
| Facility | $144.54 | $144.54 | $144.54 | |
BCBS
| Professional | $144.54 | $144.54 | $144.54 | |
Molina
| Professional | $39.81 | $39.81 | $39.81 | |
United
| Facility | $95.50 | $95.50 | $128.82 | |
United
| Professional | $44.67 | $64.57 | $239.88 |