| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $346.74 | $346.74 | $346.74 | |
Aetna
| Professional | $346.74 | $346.74 | $346.74 | |
BCBS
| Facility | $371.54 | $870.96 | $1,659.59 | |
BCBS
| Professional | $275.42 | $288.40 | $302.00 | |
Health Alliance Plan
| Facility | $346.74 | $346.74 | $346.74 | |
Health Alliance Plan
| Professional | $346.74 | $346.74 | $346.74 | |
United
| Facility | $281.84 | $281.84 | $281.84 | |
United
| Professional | $4,786.30 | $4,786.30 | $4,786.30 |