| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $123.21 | $164.28 | $164.49 | |
BCBS
| Facility | $199.79 | $235.05 | $270.31 | |
CareSource
| Facility | $149.36 | $194.17 | $235.31 | |
Health Alliance Plan
| Facility | $123.21 | $164.28 | $164.28 |