| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $368.46 | $368.46 | $368.46 | |
Aetna
| Professional | $368.46 | $368.46 | $368.46 | |
BCBS
| Professional | $1,610.00 | $1,610.00 | $1,610.00 | |
Medcost
| Facility | $368.46 | $368.46 | $534.27 |