| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $812.83 | $812.83 | $812.83 | |
Aetna
| Professional | $204.17 | $257.04 | $257.04 | |
BCBS
| Professional | $851.14 | $851.14 | $851.14 | |
United
| Professional | $446.68 | $446.68 | $446.68 |