| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $162.63 | $162.63 | $162.63 | |
Aetna
| Professional | $162.63 | $162.63 | $182.95 | |
BCBS
| Facility | $1,283.77 | $1,557.91 | $2,095.89 | |
United
| Professional | $153.59 | $197.48 | $288.01 |