| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $524.14 | $524.14 | $524.14 | |
Aetna
| Professional | $293.04 | $524.14 | $524.14 | |
BCBS
| Facility | $3,761.90 | $4,565.24 | $6,141.72 | |
BCBS
| Professional | $170.00 | $170.00 | $170.00 |