| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $64.57 | $64.57 | $64.57 | |
Aetna
| Professional | $61.66 | $64.57 | $275.42 | |
BCBS
| Facility | $147.91 | $295.12 | $562.34 | |
Health Alliance Plan
| Facility | $64.57 | $64.57 | $64.57 | |
Health Alliance Plan
| Professional | $61.66 | $64.57 | $158.49 | |
United
| Facility | $77.62 | $100.00 | $316.23 |