| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $191.77 | $191.77 | $191.77 | |
Aetna
| Professional | $103.07 | $152.94 | $191.77 | |
BCBS
| Facility | $1,417.53 | $1,720.24 | $2,314.28 | |
BCBS
| Professional | $137.00 | $137.00 | $137.00 |