| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $549.54 | $2,344.23 | $4,897.79 | |
BCBS
| Facility | $81.28 | $537.03 | $537.03 | |
Health Alliance Plan
| Facility | $416.87 | $1,071.52 | $4,897.79 | |
United
| Facility | $4,897.79 | $10,000.00 | $12,882.50 |