| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $645.65 | $645.65 | $1,122.02 | |
Aetna
| Professional | $645.65 | $645.65 | $1,819.70 | |
BCBS
| Professional | $489.78 | $489.78 | $489.78 | |
Lucent Health
| Facility | $100.00 | $100.00 | $100.00 |