| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $161.53 | $215.38 | $215.38 | |
BCBS
| Facility | $257.77 | $261.16 | $353.34 | |
CareSource
| Facility | $195.50 | $254.15 | $308.02 | |
Health Alliance Plan
| Facility | $183.07 | $215.38 | $215.38 |