| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $234.42 | $234.42 | $234.42 | |
Aetna
| Professional | $117.49 | $234.42 | $446.68 | |
BCBS
| Facility | $46.77 | $60.26 | $416.87 | |
BCBS
| Professional | $44.67 | $46.77 | $52.48 | |
Health Alliance Plan
| Facility | $234.42 | $234.42 | $234.42 | |
Health Alliance Plan
| Professional | $117.49 | $234.42 | $234.42 |