| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $75.20 | $75.20 | $75.20 | |
Aetna
| Professional | $25.18 | $70.50 | $75.20 | |
BCBS
| Facility | $34.86 | $34.86 | $34.86 | |
BCBS
| Professional | $33.13 | $36.26 | $47.07 | |
Health Alliance Plan
| Facility | $41.24 | $41.24 | $75.20 | |
Health Alliance Plan
| Professional | $41.24 | $42.89 | $75.20 | |
United
| Professional | $44.28 | $52.10 | $115.57 |