| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $161.58 | $161.58 | $161.58 | |
Aetna
| Professional | $116.55 | $161.58 | $161.58 | |
BCBS
| Facility | $2,559.86 | $3,106.51 | $4,179.26 | |
BCBS
| Professional | $135.00 | $135.00 | $135.00 |