| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $428.54 | $428.54 | $428.54 | |
BCBS
| Facility | $505.99 | $677.90 | $1,048.78 | |
BCBS
| Professional | $197.86 | $216.60 | $281.16 | |
Health Alliance Plan
| Facility | $123.99 | $2,878.00 | $4,933.00 | |
Health Alliance Plan
| Professional | $123.99 | $171.34 | $330.00 |