| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $79.00 | $79.00 | $79.00 | |
Aetna
| Professional | $79.00 | $79.00 | $79.00 | |
BCBS
| Facility | $86.10 | $86.10 | $129.15 | |
BCBS
| Professional | $86.10 | $86.10 | $87.82 | |
United
| Professional | $176.35 | $195.94 | $244.93 |