| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $25.31 | $25.31 | $25.31 | |
BCBS
| Facility | $247.23 | $247.23 | $247.23 | |
BCBS
| Professional | $48.91 | $51.48 | $69.50 | |
Health Alliance Plan
| Professional | $25.31 | $25.31 | $29.19 | |
United
| Professional | $24.12 | $27.08 | $27.08 |