| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $177.46 | $177.46 | $177.46 | |
Aetna
| Professional | $177.46 | $177.46 | $177.46 | |
BCBS
| Facility | $368.59 | $368.59 | $368.59 | |
BCBS
| Professional | $250.00 | $344.18 | $570.15 | |
Medcost
| Facility | $172.33 | $172.33 | $177.46 | |
United
| Professional | $232.44 | $319.64 | $417.54 |