| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $76.53 | $102.04 | $102.04 | |
BCBS
| Facility | $144.41 | $187.23 | $257.77 | |
CareSource
| Facility | $91.85 | $119.41 | $144.66 | |
Health Alliance Plan
| Facility | $86.74 | $102.04 | $131.83 |