| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $22.90 | $22.90 | $22.90 | |
BCBS
| Professional | $21.76 | $24.04 | $28.63 | |
Health Alliance Plan
| Facility | $77.16 | $77.16 | $77.16 | |
Health Alliance Plan
| Professional | $57.72 | $77.16 | $91.84 | |
United
| Professional | $78.50 | $95.68 | $135.19 |