| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $134.97 | $134.97 | $135.15 | |
Aetna
| Professional | $177.72 | $212.83 | $247.90 | |
BCBS
| Facility | $8.01 | $11.00 | $19.50 | |
Health Alliance Plan
| Facility | $134.97 | $947.16 | $947.16 | |
Health Alliance Plan
| Professional | $28.95 | $947.16 | $947.16 |