| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $79.45 | $79.45 | $79.45 | |
Aetna
| Professional | $50.93 | $73.09 | $79.45 | |
BCBS
| Professional | $83.49 | $83.49 | $104.36 | |
Medcost
| Facility | $51.73 | $79.45 | $152.65 | |
Medcost
| Professional | $33.15 | $33.15 | $33.15 | |
United
| Professional | $27.76 | $65.88 | $84.70 |