| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $65.92 | $65.92 | $65.92 | |
Aetna
| Professional | $31.69 | $61.80 | $65.92 | |
BCBS
| Facility | $33.24 | $33.24 | $34.86 | |
BCBS
| Professional | $33.13 | $34.90 | $47.07 | |
Health Alliance Plan
| Facility | $41.24 | $41.24 | $65.92 | |
Health Alliance Plan
| Professional | $41.24 | $42.89 | $65.92 | |
United
| Professional | $55.93 | $69.26 | $110.85 |