| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $97.72 | $4,897.79 | $4,897.79 | |
BCBS
| Facility | $77.62 | $77.62 | $123.03 | |
Health Alliance Plan
| Facility | $97.72 | $257.04 | $4,897.79 | |
United
| Facility | $707.95 | $2,630.27 | $6,025.60 |