| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $71.69 | $71.69 | $753.00 | |
Aetna
| Professional | $70.00 | $70.00 | $71.69 | |
Horizon BCBS
| Professional | $44.77 | $141.00 | $159.00 | |
United
| Professional | $42.00 | $214.00 | $300.00 |