| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $57.67 | $57.67 | $57.67 | |
Aetna
| Professional | $57.67 | $57.67 | $57.67 | |
BCBS
| Facility | $0.02 | $0.03 | $0.03 | |
BCBS
| Professional | $78.33 | $89.13 | $91.93 | |
United
| Professional | $41.94 | $62.92 | $104.86 |