| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $117.25 | $127.56 | $140.32 | |
BCBS
| Professional | $190.00 | $190.00 | $190.00 | |
Providence
| Facility | $216.32 | $216.32 | $216.32 | |
Providence
| Professional | $131.02 | $196.55 | $283.50 |