| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $194.52 | $194.52 | $194.52 | |
Aetna
| Professional | $194.52 | $194.52 | $194.52 | |
BCBS
| Facility | $279.24 | $279.24 | $279.24 | |
BCBS
| Professional | $225.00 | $266.00 | $427.35 | |
Medcost
| Facility | $188.89 | $188.89 | $194.52 | |
United
| Professional | $209.00 | $232.44 | $313.16 |