| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $394.65 | $394.65 | $394.65 | |
Aetna
| Professional | $97.14 | $97.14 | $103.22 | |
BCBS
| Facility | $103.22 | $107.26 | $113.33 | |
BCBS
| Professional | $109.29 | $109.29 | $109.29 | |
United
| Professional | $30.06 | $101.19 | $101.19 |