| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $20.00 | $20.00 | $20.00 | |
BCBS
| Facility | $3.12 | $4.28 | $7.84 | |
Health Alliance Plan
| Facility | $26.19 | $26.19 | $26.19 | |
Health Alliance Plan
| Professional | $5.00 | $26.19 | $26.19 |