| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $173.57 | $221.71 | $221.71 | |
Aetna
| Professional | $18.32 | $60.61 | $358.18 | |
BCBS
| Facility | $8.01 | $11.00 | $19.50 | |
Health Alliance Plan
| Facility | $173.57 | $221.71 | $861.07 | |
Health Alliance Plan
| Professional | $119.70 | $861.07 | $861.07 |