| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,634.88 | $4,933.00 | $5,757.00 | |
BCBS
| Facility | $18,443.04 | $21,646.71 | $29,327.86 | |
Health Alliance Plan
| Facility | $1,373.15 | $4,933.00 | $5,757.00 | |
United
| Facility | $4,635.00 | $10,192.00 | $12,767.00 |