| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $162.18 | $162.18 | $162.18 | |
Aetna
| Professional | $162.18 | $162.18 | $194.98 | |
Ambetter
| Professional | $100.00 | $102.33 | $107.15 | |
BCBS
| Facility | $181.97 | $181.97 | $181.97 | |
BCBS
| Professional | $181.97 | $181.97 | $186.21 | |
Christus
| Facility | $131.83 | $131.83 | $131.83 | |
United
| Facility | $104.71 | $112.20 | $128.82 | |
United
| Professional | $162.18 | $186.21 | $199.53 |