| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $331.19 | $331.19 | $331.19 | |
Aetna
| Professional | $238.28 | $331.19 | $331.19 | |
BCBS
| Facility | $1,504.18 | $1,825.39 | $2,455.73 | |
BCBS
| Professional | $480.00 | $480.00 | $480.00 |