| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $801.85 | $4,933.00 | $5,757.00 | |
BCBS
| Facility | $2,926.86 | $3,435.27 | $4,654.25 | |
Health Alliance Plan
| Facility | $693.96 | $4,933.00 | $5,757.00 | |
United
| Facility | $4,635.00 | $10,192.00 | $12,767.00 |