| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $176.55 | $176.55 | $247.17 | |
Aetna
| Professional | $176.55 | $176.55 | $176.55 | |
BCBS
| Facility | $164.69 | $164.69 | $247.04 | |
BCBS
| Professional | $164.69 | $164.69 | $167.98 | |
United
| Professional | $136.80 | $136.80 | $176.55 |