| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $451.50 | $451.50 | $451.50 | |
BCBS
| Facility | $231.26 | $231.26 | $231.26 | |
BCBS
| Professional | $219.70 | $240.51 | $312.20 | |
Health Alliance Plan
| Facility | $69.59 | $2,056.00 | $4,933.00 | |
Health Alliance Plan
| Professional | $69.59 | $81.43 | $316.80 |