| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $92.15 | $129.01 | $287.51 | |
Aetna
| Professional | $64.88 | $92.15 | $92.15 | |
BCBS
| Facility | $120.52 | $120.52 | $120.52 | |
BCBS
| Professional | $114.49 | $120.52 | $134.06 | |
Health Alliance Plan
| Facility | $92.15 | $129.01 | $287.51 | |
Health Alliance Plan
| Professional | $92.15 | $110.31 | $137.76 | |
United
| Professional | $80.98 | $118.36 | $180.03 |