| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,687.55 | $4,933.00 | $5,757.00 | |
BCBS
| Facility | $18,174.04 | $21,330.98 | $28,900.09 | |
Health Alliance Plan
| Facility | $1,377.87 | $4,933.00 | $5,757.00 | |
United
| Facility | $5,356.00 | $11,464.00 | $15,000.00 |