| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $80.84 | $80.84 | $113.18 | |
Aetna
| Professional | $80.84 | $80.84 | $80.84 | |
BCBS
| Facility | $76.80 | $76.80 | $115.20 | |
BCBS
| Professional | $76.80 | $76.80 | $78.34 | |
United
| Professional | $80.84 | $80.84 | $89.13 |