| 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 | $104.86 | $204.81 | $236.83 | |
BCBS
| Professional | $89.13 | $104.86 | $170.84 | |
United
| Professional | $41.94 | $83.89 | $104.86 |