| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $861.06 | $861.06 | $861.06 | |
BCBS
| Facility | $260.02 | $260.02 | $260.02 | |
BCBS
| Professional | $247.03 | $270.43 | $351.04 | |
Health Alliance Plan
| Facility | $2,056.00 | $2,056.00 | $4,933.00 | |
Health Alliance Plan
| Professional | $237.99 | $604.16 | $861.06 |