| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $127.79 | $127.79 | $127.79 | |
Aetna
| Professional | $127.79 | $156.47 | $156.47 | |
BCBS
| Facility | $1,131.73 | $1,373.40 | $1,847.67 | |
United
| Professional | $132.46 | $172.29 | $277.24 |