| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $548.14 | $2,877.00 | $4,933.00 | |
BCBS
| Facility | $24,604.79 | $28,878.79 | $39,126.18 | |
Health Alliance Plan
| Facility | $562.03 | $2,877.00 | $4,933.00 | |
United
| Facility | $4,635.00 | $10,192.00 | $12,767.00 |